[THE INDICATORS OF COAGULATION HEMOSTASIS AFTER CRIO-RESECTION OF LIVER].

The article presents results of comparative evaluation of indicators of coagulation hemostasis in 24 patients with focal parasitic and non-parasitic pathology of liver before and after resection of organ with and without frigotherapy. The analysis of condition of coagulation hemostasis was implemented on the basis of results of blood clotting tests and immune enzyme technique of detection of content of factors V, Xl, XII in blood plasma. It is demonstrated that after crio-resection of liver the tendency to normalization of content of factors V and XI is more expressed than in case of common resection of organ.

[The repeated operations for focal liver lesions].

Repeated operations for focal liver lesions were analyzed. 75 patients with parasitic liver lesions (alveococcosis, echinococcosis), 14 patients with liver tumors, 15 patients with cysts and abscesses were included in the study. For the first time patients underwent palliative operations or diagnostic laparotomy.

[Cryosurgery of hepatic tumors].

The work presents an experience with cryosurgical treatment of malignant and benign tumors of the liver in 110 patients. The cryosurgery was performed using an original apparatus. The methods of resection of the liver using cryosurgical instruments are described which reduce the intraoperative blood loss and facilitate visualization of the vascular-tubular structures along the resection line.

[Sucking effect of diaphragm and its significance in drainage of abdominal cavity during hepatic surgery].

Investigation of the value of the sucking effect of the diaphragm in 44 patients was carried out. The first group consisted of 28 patients who have not undergone hepatic resection. The second group included patients after hepatic resections of various volume in local pathology.

[The effect of immune system disorders on the incidence of inflammatory complications in surgeries on the liver].

Inflammatory complications in the abdominal cavity are the most frequent complications after operations on the liver. Immunological studies were conducted in 71 patients with local lesions of the liver who had undergone various surgical interventions. Cellular and humoral immunity factors were studied.

[Complications after resection of the liver].

On the basis of experience in 228 radical resections of the liver (3.9% lethality) for focal affections, the authors analyze the causes of occurrence and measures of prevention of the main postoperative complications. The following factors play a role in the development of complications after liver resection: the patient's age, the character of the main and concomitant pathology, the volume of the operation and intraoperative blood loss, and the method of drainage.

[Drainage of the abdominal cavity after resection of the liver because of tumors].

After resection of the liver for benign and malignant tumours, 20 (44.4%) of the 45 patients developed purulent complications in the abdominal cavity. In most of them, ineffective drainage of the abdominal cavity was the main cause of such complications.

[Treatment of abscesses of the upper abdominal cavity after surgery on the liver].

Complications after 454 various operations on the liver are analysed. Abscesses of the upper part of the abdominal cavity (subdiaphragmatic and subhepatic abscesses, suppuration of residual cavities after resection of the liver and echinococcotomy) developed in 18.5% of patients in the postoperative period.

[Device for abdominal drainage].

A device for draining the abdominal cavity is suggested consisting of a system of 4-5 tubes with openings in the sides. The tubes of the system are joined to form a loosely coiled braid with a large coil pitch, while the axes of the side openings in the tubes are arranged on the helicoidal line with a pitch differing from that of the braid. This design of the device makes it possible to avoid obstruction of the side openings of the drain by the mobile organs and tissues of the abdominal cavity, which considerably raises the efficacy of draining in vacuum aspiration.

[The diagnosis and treatment of mechanical jaundice of parasitic origin].

From analysis of 230 cases of obstructive jaundice consequent upon opisthorchiasis, alveococcosis, and echinococcosis its causes and the peculiarities of the clinical course were revealed: gradual development, a long duration, disturbed hepatocyte function in the early period, high incidence of cholangitis, deep disorders of immunological reactivity, and allergic reorganization of the organism. With due regard for these characteristics, recommendations are given in respect of the diagnosis, operative treatment, prevention of postoperative complications, and postoperative management.

[A rare case of infiltrative growth of alveococcus in the aorta and its branches].

Widespread liver alveococcosis resulted in the infiltrative growth into the celiac and superior mesenteric arteries with their complete obturation with the parasitic tissue, but without the disturbance of circulation in the digestive organs. This was due to slow obliteration and the development of collateral circulation.

[The role of determining the level of middle molecules in patients in the diagnosis and treatment of suppurative-inflammatory complications after operations on the liver and pancreas].

Investigations of the level of medium-mass molecules were performed in blood plasma of 52 patients in dynamics after different operations on the liver and pancreas. Significant elevation of the level of medium-mass molecules was noted in patients with pyo-inflammatory complications. The inverse relationship between the level of medium-mass molecules and the prognostic coefficient value (the ratio of the general plasma protein to the general protein of wound discharge) was revealed.

[Opisthorchiasis of the liver].

The authors discuss 34 patients with opisthorchiasis cysts of the liver, 17 of them were treated by operation. The disease is not a rare occurrence in endemic foci. Ultrasonography is considered to be the most informative method in the diagnosis of opisthorchiasis hepatic cysts.

[The late results of liver resection in repeat operations].

Long-term results after resections of the liver in reoperated patients are described. The operations were performed on 48 patients. Four of them died (8.

[Ultrasonic diagnosis of complications in repeated surgery of the liver].

Ultrasonic examination is an effective noninvasive method in the diagnosis of complications in reoperations on the liver. With the application of the method the cavity of disintegration and sequestration were diagnosed in 86% of patients with complicated alveococcosis. Affection of the elements of the porta hepatis and inferior vena cava was revealed in 82% of patients, which was very important in determining the operability of the process and was of essential significance in planning the volume of liver resection.

[The classification of cryosurgical resections of the liver in reoperated patients].

The authors present a classification of cryosurgical operations in resection of the liver in reoperated patients. The basis of this classification is different combination of usual and cryosurgical (cryoresection and cryodestruction) methods, which allow to increase the radicality of the operations. Ten kinds of cryointerventions (5 radical and 5 palliative) were established.

[Surgical treatment of cysts and fistulas of the pancreas].

Forty-six patients were treated for cysts and fistulas of the pancreas most of which were caused by destructive pancreatitis and trauma of the pancreas. Operations were performed for pancreatic cysts on 22 patients: marsupialization of the cyst (7 patients), cystoenteroanastomosis (11), resection of the gland together with the cyst (3 patients, one of them died), and cytogastroanastomosis (1). Operations for pancreatic fistulas were carried out in 16 patients.