Grechikhin G. Optimization of diagnostic and treatment tactics for hypersplenism in cirrhotic patients

The object of the study was 126 cirrhotic patients with hypersplenism. The aim of this study was to improve the results of surgical treatment for hypersplenism in cirrhotic patients. During the study clinical and ultrasound, angiographic, biochemical, immunological and statistical methods were used. The study obtained new data on the effectiveness of various methods of surgical treatment for hypersplenism in cirrhotic patients. For a practical medicine algorithm of diagnostic and treatment tactics, which allows defining indications for various methods of surgical treatment, to reduce the frequency and severity of postoperative complications, to reduce postoperative mortality and the number of relapses hypersplenism after surgery was proposed. For the first time indications for various techniques of embolization of splenic artery for hypersplenism in cirrhotic patients were identified. Metal spiral for preoperative endovascular occlusion of the splenic artery, which allows a quicker removing of the clinical manifestations of hypersplenism, was designed. The various types of immune response in cirrhotic patients with hypersplenism and their impact on the immediate and long-term treatment results were identified.The differentiated treatment tactics for hypersplenism in cirrhotic patients was theoretically grounded, developed and introduced into practice, its effectiveness was proved. The research results were introduced into practical work of departments of endovascular surgery, of emergency surgery of the abdominal cavity, of the liver and biliary tract diseases in "Institute of General and Urgent Surgery of AMS of Ukraine", the surgical department of "Kharkiv regional clinical trauma hospital", minimally invasive surgical treatment department of "Kharkiv clinical emergency medical aid hospital". The obtained results can be used in work of departments of general surgery, surgical centers of hepatology and interventional radiology.