Tkachuk O. Preventive maintenance and correction of post-decompression liver dysfunctions in complex surgical treatment at patients with obstructive jaundices

The dissertation is devoted to improve the early and late results of surgical treatment of patients with obstructive jaundices bile stone or malignant etiology with the application of miniinvasive technologies. The pathogenesis theory of syndrome biliary decompression is formulated on the base of the analyzing results of clinical and laboratory tests. It also includes a choice of the optimal surgical tactics, adequate operative intervention and drugs for preventive maintenance and treatment of post surgery dysfunctions of a liver at patients with obstructive jaundices. It has been investigated the influence of miniinvasive bile evacuation on functional condition of bilious ways, vascular channel and tissue of liver. It also has been proved that unlike dosed out decompression of bilious ways while imposing bile-digestive bypass, endoscope bile tracts endoprosthesis at malignant obstructive jaundices causes considerably smaller postdecompressiv postoperative hepatic dysfunctions. Dosed out decompressionof bilious ways, short time arterializations of portal blood supply and application of Berlithion cause decrease of symptoms hepatic dysfunction. The realization of developed surgical tactic of rational and staged bile draining operations with the using of miniinvasive technologies has allowed to decrease the rate of postoperative complications for 6%; and postoperative lethality from 21 to 12%.