Mostyuk E. Forecast and prevention of postoperative liver failure in obstructive jaundice (on the basis of morphological and functional changes)

The thesis is devoted to study of morphological and functional changes in the liver tissue of obstructive jaundice developed criteria for selection of surgical tactics in patients with benign obstructive jaundice with the risk of liver failure, improvements to existing, developed new original methods of diagnosis and surgical treatment.In clinical studies using the developed diagnostic criteria identified a group of patients with morphological and functional abnormalities in liver tissue against the severity of inflammation, high and prolonged obstructive jaundice, which proved the feasibility of staged surgical approach for the prevention of postoperative liver failure. Also identified a group of patients with the absence of morphological and functional disturbances in the liver tissue in patients without inflammatory processes at low and acute jaundice, which use staged surgical approach was appropriate in the presence of the possibility of recovery chole leading by endoscopic method. Because of this, the redistribution of patients with complicated and uncomplicated obstructive jaundice in the study group was more appropriate than in the comparison group. This allowed for the optimal choice of surgical approach using a phased approach. This approach to the treatment of patients with obstructive jaundice allowed to reduce the number of postoperative complications associated with the development of liver failure, by 9,35 %, and the mortality rate - to reduce by 4,1 %.