[Vascular reconstruction and transplantation technologies in liver surgery (part II)].

Objective: To systematize tactical and technical aspects of liver resections with reconstruction of afferent and efferent blood supply and/or inferior vena cava; to study postoperative outcomes in patients with focal liver lesions using transplantation technologies.

Material And Methods: We enrolled 413 patients with parasitic lesions, primary and secondary liver tumors involving great vessels (portal vein, hepatic artery, hepatic veins, inferior vena cava, right atrium). All ones underwent liver resections with vascular resection and reconstruction, as well as liver autotransplantation in vivo, ante situ (ex situ in vivo), extracorporeal liver resections with autotransplantation (ex vivo).

[Vascular reconstructions and transplant technologies in liver surgery (part I)].

Objective: To systematize technical aspects of liver resections with reconstruction of afferent and efferent liver blood supply and/or inferior vena cava, as well as to analyze the results of surgical treatment in patients with focal liver lesions.

Material And Methods: The study included 413 patients with parasitic lesions, primary and secondary liver tumors with great vessel invasion (portal vein, hepatic artery, hepatic veins, inferior vena cava, right atrium). These features excluded radical liver resections without vascular resection and reconstruction, as well as liver autotransplantation in vivo, liver autotransplantation ante situ (ex situ in vivo), extracorporeal liver resections with autotransplantation (ex vivo).

H-shaped partial splenorenal shunting with the use of a reinforced graft made of porous polytetrafluoroethylene.

Aim: The study was aimed at improving the immediate and remote results of splenorenal bypass grafting.

Patients And Methods: A total of 57 patients presenting with hepatic cirrhosis, portal hypertension, and recurrent haemorrhage from oesophageal varices underwent an H-shaped partial splenorenal shunt procedure using an externally reinforced 1.5-2.

[Use of polytetrafluoroethylene grafts for reconstruction of major veins of mesenteric-portal system].

Surgical management of patients with tumour invasion of major veins by means of their resection and simultaneous reconstruction is an actively developing trend in modern surgery. The article describes a clinical case report concerning treatment of a patient presenting with disseminated neuroendocrine cancer of the pancreatic head and subjected to pancreatoduodenal resection with a complicated variant of mesenteric-portal reconstruction and the use of a graft made of porous polytetrafluoroethylene, followed by relapse-free survival of more than 5 years. In our case report, despite complexity of forming a proximal anastomosis, the findings of multislice computed tomography with 3D-reconstruction 4 months after the operation demonstrated uneven circular thickening of the graft's wall by 1-2 mm, which might be interpreted as neointimal hyperplasia.

[Influence of pancreatic segment graft autotransplantation on its exocrine function].

In experiments on dogs the exocrine secretion of pancreatic segment graft after its autotransplantation and of pancreatic stamps after proximal resection of the pancreas was investigated. More significant impairment of the exocrine secretion of the pancreas was revealed in animals after pancreatic graft autotransplantation in comparison with animals after the proximal resection of the pancreas. Maintenance of the adaptation of pancreatic exocrine secretion to the nutritional composition of the intestinal contents and "generalized inhibition" of pancreatic exocrine secretion caused by duodenal trypsin infusion was revealed in all groups.