KOTENKO O. Surgical treatment of complicated liver cirrhoris.

The thesis is devoted to issues of the pathogenesis, diagnosis and surgical treatment of liver cirrhosis complications. There were investigated the changes of hepatosplanchnic blood circulation in cirrhosis and their interrelationship with the hepatic function disorder, portosystemic encephalopathy, portal gastropathy the vein's varicose localisation and severity. Precise indications for various operative interventions, depending on the regional hemodynamics state, were suggested. Basing on the investigation results the rational tactics of surgical treatment of 280 patients with complicated liver cirrhosis were elaborated, including combination of portodecompressive, lymphodecompressive and dividing operations, which was directed on the complications correction, the disease course stabilization and the life span enhancement. New methods of operations as well as surgical tactics have permitted to prevent the development and progress of portosystemic encephalopathy, portal gastropathy, that promoted the significant improvement of the life quality. When compared with conventional metods, the new strategy introduction have provided decrease of mortality rate from 24 to 16,4%, the hemorrage recurrency from 30,3 to 12,5%, portosystemic encephalopathy rate from 48,3 to 21,5%, and increase of mean 3-year survival from 40 to 53%.