Surgical treatment and prognostic factors in perihilar tumors.

Objective: To study the results of surgical treatment in patients with perihilar tumors.

Material And Methods: We analyzed 98 patients with perihilar tumors who underwent surgery.

Results: We prefer percutaneous transhepatic biliary drainage (=58) for jaundice.

Irreversible electroporation in locally advanced pancreatic cancer.

Objective: To determine the feasibility of irreversible electroporation (IRE) for locally advanced pancreatic adenocarcinoma.

Material And Methods: Twenty-three patients underwent IRE after chemotherapy for locally advanced pancreatic cancer between 2015 and 2022. IRE was performed during laparotomy as a rule (=22).

[IMMUNOLOGICAL FACTORS OF THE INNATE IMMUNITY IN PATIENTS WITH HEPATOCELLULAR CARCINOMA OF A LARGE SIZE].

Factors of the inborn immunity in patients, suffering hepatocellular carcinoma of large size, were studied. Preoperatively the raising of metabolic activity of neutrophils in spontaneous NST-test, the neutrophils reserve reduction in NST-test, weak activation of the neutrophils absorption function in a phagocytosis reaction were noted. On the 7-8th postoperative day a reduction of quantity of formazan--positive neutrophils in spontaneous NST--test, raising of reserve of the neutrophils metabolic activity, comparing with initial values, were observed.

[ROENTGEN-ENDOVASCULAR EMBOLIZATION OF THE PORTAL VEIN BRANCHES AS A PATIENTS CONDITIONING FOR EXTENSIVE HEPATIC RESECTION].

The results of surgical treatment of 316 patients, suffering focal hepatic diseases, in whom for preoperative preparation a portal vein embolization (PVE) was performed, were analyzed. PVE was applied in a small planned hepatic residual volume. The patients have aged from 21 to 77 yrs, (57 ± 10.

[Results of preoperative embolization of portal vein in patients with biliary hepatic tumors].

The results of preoperative embolization of portal vein (EPV) in 90 patients, operated on for biliary hepatic tumors, were analyzed. In 47 patients Klatskin tumor was revealed, in 29--peripheral cholangiocarcinoma, in 14--tumor of a gallbladder. In all the patients a radical major hepatic resection was planned, a checking hepatic volume (CHHV) did not exceed 40% of a noninvolved parenchyma.

[Preoperative portal vein embolization: dynamics of portal pressure].

The pressure dynamics was studied in a portal vein (PV) in patients, suffering focal hepatic pathology, to whom portal vein embolization (PVE) was performed as a stage of preparation to radical hepatic resection. In 236 patients the immediate measurement of pressure in a PV was performed intraoperatively before and after PVE, in 26 - catheter for control portography and monitoring of pressure in a PV was left in its trunk for 24 h postoperatively. There was noted a pressure rising in a PV immediately after its embolization by 86.

[Functional state of the liver in patients, suffering chronic abscess after the organ resection].

The results of treatment of 55 patients, in whom hepatic resection was performed in 2004-2011 yrs, were analyzed. In 30 patients (main group) various kinds of hepatic resection was done for chronic abscess of the organ; in 25 (control group)--hepatic resection was conducted for hepatic tumors. In both groups o patients a comparative estimation of hepatic functional state after the organ resection was conducted in accordance to albumin level in the blood serum, the coagulogram indices, integral ration of transferases activity and a bilirubin content.

[The portal vein reconstruction during operations for hepatocellular carcinoma].

There was the objective to improve the results of treatment in patients, suffering hepatocellular carcinoma (HCC) with vena cava invasion by the tumor. In the main group a hepatic resection with the portal vein resection and portoplasty was performed in 21 patients, suffering HCC with vena cava invasion by the tumor of second-third degree (according to J. Shi, 2007); in a control group in 61 patients, suffering the portal vein tumoral invasion of first degree, the hepatic resection only was done.

[Antibacterial therapy in surgical treatment of chronic hepatic abscess].

The results of surgical treatment of 58 patients for chronic hepatic abscess were presented. In patients of the main group hepatic resection was performed and in a control one--sanation and drainage of the abscess cavity. Antibacterial therapy was conducted in patients of both groups before and after operative treatment.

[Peculiarities of the venous bed vessels reconstruction while performing liver transplantation from live relative donor in children].

The rate of hepatic transplantation from live relative donor in children is increasing in all over the world and in Ukraine as well. Significant incidence of the pathology together with necessity of technically complex intervention performance causes the need for surgical technique improvement, a new methods elaboration and clinical introduction, permitting to lower the postoperative complications rate. Technical complexity constitutes the main peculiarity of transplantation operation of liver, obtained from live relative donor, in children, it is caused by the vessels small diameter, pathological changes of the recipient portal vein and lack of plastic material for reconstruction of vessels.

[Hepatic and the portal vein resection in the surgical treatment of hepatocellular carcinoma].

Modern problems of the portal vein resection while hepatectomy performance are enlighted. Indications for resection of the portal vein bifurcation zone are adduced, various methods of portoplasty are depicted. New methods of the portal vein passability restoration in disparity of its sutured parts diameters are proposed.

[Peculiarities of splanchnic hemodynamics after performance of partial portosystemic shunting].

Complex hemodynamical investigations were conducted in 1985-2004 yrs in 60 patients with hepatic diseases before the operation, in 6-8 and 12-24 months after performance of portosystemic shunting operation (in 26 patients was formed H-like mesentericocaval anastomosis, in 10--central splenorenal anastomosis, in 14--splenorenal anastomosis side-to-side, in 10--H-like splenorenal anastomosis). Performance of shunting operation had promoted the lowering of volumetric speed of blood flow and pressure in portal vein, her diameter reduction, the general hepatic blood flow lowering. The lowering of blood flow in the portal vein system after the shunting have caused enhancement of arterial hepatic blood flow.

[Portal reconstruction in hepatectomy with resection of portal vein].

Modern issues of the portal vein resection while hepatectomy conduction are enlighten. The indications for resection of region of the portal vein branches confluence were substantiated, various methods of portoplasty were depicted. New methods of the portal tract passability restoration in discrepancy of diameters of the sutured portal vein portions were proposed.

[Radical methods in the treatment of liver hemangioma].

Experience of hepatic resection in 93 patients, performed for hemangioma is presented. Anatomic hepatic resection was done in 54 (58.1%) of patients, atypical one--in 22 (23.

[The effect of pentagastrin and substance P on the gastric parietal glandulocytes].

Investigations on dogs show that substance P suppresses pentagastrin gastric acid secretion. This effect is abolished by acetylcholinesterase block by calimin. The results indicate that pentagastrin and substance P participate in cholinergic regulation of gastric acid secretion.

[Mechanisms of stomach secretion in dogs infused with histamine, carbacholine and pentagastrin].

In chronic experiments on dogs with Basov 's stomach fistulas and pvc catheters implanted into the jugular vein the authors studied the effects of noradrenaline and adrenaline (30 mg/kg) on gastric secretion stimulated by pentagastrin. It was shown that the adrenagonists suppressed the pentagastrin-stimulated gastric secretion. The suppressing effect lasted 90 minutes after discontinuation of adrenaline or noradrenaline infusion.

[Effect of beta-adrenoreceptor stimulation on gastric secretion stimulated by histamine, acetylcholine, and pentagastrin].

In chronic experiments on dogs with gastric and duodenal fistulas and catheters implanted into the jugular vein, it was established that the beta-adrenoagonist novodrin inhibits gastric secretion stimulated with acetylcholine or pentagastrin but does not alter secretion stimulated with histamine. The inhibitory effect of novodrin on gastric secretion is a consequence of its direct action on beta-adrenoreceptors of the gastric mucosa. The scheme demonstrating interrelations of beta-adrenoreceptors to acetylcholine, gastrin and histamine is offered.

[Effect of the adrenomimetics noradrenaline and mezaton on gastric secretion clinically and experimentally].

Chronic tests on dogs with fistulas in the fundal portion of the stomach and polychlorvinyl catheters implanted in the jugular vein brought evidence that infusion of norepinephrine or mesaton in a dose of 0.003-0.004 mg/kg for 1 1/2 and more hours inhibited the gastric secretion stimulated with carbocholine and histamine.

[Effect of histamine and insulin on the sterol composition of gastric secretions in dogs].

The effect of gastric secretion activators with a different mode of action was studied on the qualitative and quantitative composition of sterol in dog gastric juice. Cholesterol was established to be the basic component of the unsaponifiable fraction of both histamine- and insulin-stimulated gastric juice. The presence of unsaponifiable substances and cholesterol was much higher in the histamine-stimulated gastric juice.