ABSTRACT
The authors had 302 patients with focal lesions of the liver, 232 of them were operated on. Radical operations were carried out on 96 and palliative operations on 136 patients. Operations were performed for a second time in 35 patients, radically in 24 of them. A previously conducted exploratory laparotomy is still no evidence of inoperability of the process. In alveococcosis of the liver with no clinical signs of biliary stasis, it is advisable to consider resection of the liver after a previously conducted bile-draining operation. Patients who had been subjected to cavernotomy may also be operated on radically. The appearance of jaundice in the late-term periods after resection-fragmentation of the liver indicates growth of the remaining area of the parasitic nodus and dictates the indications for a bile-draining operation. Obstructive jaundice is considered the main indication for undertaking a palliative operation for the second time. Five patients died after surgery.
Subject(s)
Cholestasis, Intrahepatic/surgery , Cysts/surgery , Echinococcosis, Hepatic/surgery , Hepatectomy/methods , Liver Diseases/surgery , Postoperative Complications/surgery , Adolescent , Adult , Cholestasis, Intrahepatic/etiology , Female , Humans , Palliative Care , Postoperative Complications/etiology , ReoperationABSTRACT
The authors analysed 368 clinical cases with gastroduodenal hemorrhages. The changes in blood microcirculation and nonspecific immunity were studied in 62 patients. They proposed a method of complex nonoperative treatment of gastrointestinal hemorrhages, including ganglionic block, which made it possible not only to reduce the operative activity but also to achieve epithelialization of ulcers in patients with peptic ulcer. As the result of the study, a unique classification of the severity of blood loss is suggested which is based on the degree of deviation off the tests studied from the normal values. If gastroduodenal hemorrhage continues, an operation is recommended, the character of which is determined by the patient's age, the severity of blood loss, and the source of bleeding and its localization.
Subject(s)
Peptic Ulcer Hemorrhage/surgery , Duodenal Ulcer/complications , Female , Humans , Male , Methods , Microcirculation , Peptic Ulcer Hemorrhage/etiology , Peptic Ulcer Hemorrhage/physiopathology , Stomach Ulcer/complicationsABSTRACT
The authors describe their observations of 227 patients after operations for focal lesions of the liver. Radical operations were performed on 93 patients, 61 being subjected to extended, combined and associated resections of the liver. Most operations were made as atypical resections of the liver. In order to reduce the operation blood loss the authors recommend to fulfil temporary exclusion of the liver from blood circulation by compression of the hepato-duodenal ligament. The temporary external drainage of bile ducts is recommended as a preventive measure against post-operative bile peritonitis. Postoperative lethality after extended, combined and associated resections of the liver was 9.8%.
