[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.

[Radical methods in the treatment of liver hemangioma]. / Radikal'nye metody lecheniia gemangiomy pecheni.

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 (23.6%), enucleation of hemangioma--in 17 (18.3%). The least intraoperative blood loss was noted in enucleation of hemangioma and the most--in atypical hepatic resection. Complications had occurred in 15 (16.1%) patients, postoperative mortality was 1.1%.

[Transcutaneous hepatic biopsy under ultrasonographic control: options, indications, procedure, results]. / Chreskozhnaia biopsiia pod kontrolem ul'trazvukovogo issledovaniia: vozmozhnosti, pokazaniia, tekhnika, rezul'taty.

The options, indications and contraindications for conduction of transcutaneous diagnostic interventions under ultrasonographic control in diffuse and focal hepatic affection were studied up. The procedure technique of the fine-needle aspiration and the tissue hepatic biopsy was adduced. Comparative analysis of the biopsy needles owing various constructions and diameters was conducted. High efficacy of transcutaneous biopsy under ultrasonographic control for the hepatic diseases diagnosis was proved.

[The partial portosystemic shunting and its hemodynamic consequences]. / Partsial'noe portosistemnoe shuntirovanie i ego gemodinamicheskie posledstviia.

Complex hemodynamical investigations were done in 32 patients in 1985-1999 yr. period before the operation, in 6-8 and 12-24 mo after performance of the partial portosystemic shunting operation (in 8 patients mesentericocaval anastomosis was formed, in 10--central splenorenal anastomosis, in 12--splenorenal anastomosis side to side and in 2--lowermesentericorenal anastomosis). The performance of shunting operation had promoted the lowering of the blood flow volumetric velocity and of the pressure in v. cava as well, its diameter reduction, the lowering of general hepatic blood flow. The lowering of blood flow in the v. cava system after the shunting operation performance caused the arterial hepatic blood flow enhancement occurrence.

[Results of partial shunting in liver cirrhosis]. / Rezul'taty partsial'nogo shuntirovaniia pri tsirroze pecheni.

Complex hemodynamical investigations were conducted in 32 patients before the operation and after performance of partial portosystemic shunting (in 8--mesentericocaval anastomosis was done, in 10--central splenorenal one, in 12--splenorenal side-to-side, in 2--lowermesenterial-renal). The formation of anastomosis 8-10 mm in diameter had promoted the sufficient reduction of pressure in v. porta, preservation in it the hepatopetal blood flow, prophylaxis of uncontrolled occurrence of portosystemic encephalopathy, had secured the stable hepatic function during 36 months.

[Splanchnic circulation after distal splenorenal anastomosis in hepatic cirrhosis]. / Splankhnicheskoe krovoobrashchenie posle nalozheniia distal'nogo splenorenal'nogo anastomoza pri tsirroze pecheni.

While the result estimation of the distal splenorenal anastomosis formation operation, done in 12 patients according to the W. D. Warren method and in another 12 patients--according to the method, modified by K. Inokuchi, it was established that the hepatic portal perfusion loss causes compensational enhancement of blood flow in a. hepatica, including while the standard method application--by 22% and the modified one--by 8%. Doing the splenorenal venous disconnection improves the patients' quality of life due to the incidence rate of portosystemic encephalopathy reduction by 8.3%, and in this circumstances the life span and the hemorrhage recurrency rate do not differ with such while using the standard method.

[Hemodynamic and functional aspects of portal hypertension decompensation in liver cirrhosis]. / Gemodinamicheskie i funktsional'nye aspekty dekompensatsii portal'noi gipertenzii pri tsirroze pecheni.

Complex investigations of hepatoportal circulation and hepatic functional reserve were conducted in 90 patients with liver cirrhosis and the portal hypertension syndrome in the stages of compensation, sub- and decompensation. While the disease grow progressing the indexes of common hepatic blood flow and its components lowers, hyperdynamic state of splenic circulation changes to congested one. Hemodynamic disturbances mentioned are making for hepatic functional reserve worsen.

[Rationale for surgical treatment of focal liver diseases]. / Vybor ratsionalnogo sposoba khirurgicheskogo vmeshatelstva pri ochagovom porazhenii pecheni.

A 19-year experience with surgical treatment of the patients with focal hepatic lesions is presented. Hepatic resection was performed in 149 patients. Of them, 52 underwent atypical resection with the use of ultrasound aspirator, laser scalpel, temporary exclusion of the liver out of circulation, placement of staple suture of the parenchyma, preliminary roentgenovascular embolization of the major vessels of the lobe removed. A modern classification of the methods of hepatic resection reflecting most accurately a volume of the parenchyma removed is presented. The postoperative lethality was 6.08%.