Pisets'ka M. Individualization methods of temporary vascular occlusion during liver resection.

Dissertation is dedicated to resolve the problems of intraoperative blood loss during hepatic resection, and also to improve the results of surgical treatment in patients with focal liver lesions by individualization of temporary vascular hepatic exclusion. Experimental and clinical research has been done. Experimental part. Forty white giant rabbits were divided randomly into four groups (n=10 in each group). Different models of vascular exclusion were compared. The research showed that vascular occlusion with ischemic preconditioning in the mode 5/10/15 is the most optimal technique. Use of this technique cause minimal morphofunctional changes in liver. Clinical part. One hundred and fifty two consecutive liver resection were performed from 2008 to 2013. As result was proposed an algorithm application of afferent liver vascular exclusion, which has improved the results of surgical treatment of patients with focal liver lesions mainly due to the reduction of intraoperative blood loss (902 mL with up to 478 ml) and minimize the manifestations of ischemia-reperfusion syndrome. As a result noticed decreasing postoperative complications (from 32.7% to 21.6%) and mortality rate (from 5.8% to 1.96%).