Ratchik V. Diagnostics and surgical treatment subhepatic cholestasis nontumoral genesis at stages of the development of its complications (clinic-experimental research)

The dissertation is devoted to a problem of complex diagnostics and treatment of subhepatic cholestasis nontumoral genesis. On the basis of data analysis of experimental researches and clinical materials the new direction of the treatment based on definition of the differentiated approach and staging of operative interventions is developed. It was proved the expediency of performing of complex operative interventions in which bile flow correction was supplemented under indication of hepatic-regenerative operations that was accompanied by improvement of an intra-hepatic blood flow, stimulation of reparative and regenerative processes of a liver and reduction fibrotic processes. The offered complex program of treatment, has allowed to improve results and reliably (p <0.05) reduced postoperative lethality from 7.5 % in the comparing group to 1.5 % in the basic group, and postoperative complications from 8.7 % up to 2.62 % accordingly. In the long term of the postoperative period, restoration of liver's histo-structure was observed at 84.2% of patients with the offered approach against 49.5 % in the group of comparison, where signs of secondary biliary cirrhosis are noted in 9.7 times (16.5 % of patients) more often, than with patients of the basic group.