Non-invasive diagnostics of extrahepatic portal hypertension at the proliferative processes in the pancreas

The study of hemodynamics in 199 patients with chronic pancreatitis and pancreatic cancer was performed with use of radiological diagnostics methods: ultrasound research, CT and. portal scintigraphy. Ultrasound examination with color and. power Doppler, CT with 3D-reconstruction give an idea of the local hemodynamic changes in extrahepatic portal hypertension and. can identify preoperative anatomic and. topographic relationship of great vessels in their involvement in mass lesion of the pancreas. Portal scintigraphy with accuracy 83 %, sensitivity 62 % and. specificity 100 % functional condition evaluates collateral flow in extrahepatic portal hypertensio

Influence of critical hypotension on the development of postoperative hepatic failure

The article is devoted to the study of influence of critical hypotension on the development of postoperative hepatic failure. The results of treatment of 54 patients who had. anatomical and advanced anatomical resections of a liver were analyzed. Also the causes that lead to the postoperative hepatic failure such as volume of intraoperative blood loss, duration of intraoperative hypotension were analyzed. As the result of the analysis of obtained data on the influence of studied parameters (volume of blood loss, duration. of vascular isolation and presence of intraoperative hypotension) on the development of hepatic failure in postoperative period we supposed that the most unfavorable prognostic sign of its appearance is an episode of critical decrease of arterial pressure during the operation. Thus even at massive blood loss hepatic failure doesn't always appear, whereas critical intraoperative hypotension causes its development. Taking into consideration data on the state of central hemodynamics at the performing of anatomic resections of liver we determined main approaches to the infusion-transfusion therapy during excluding of liver from blood circulation for the prophylactics of its reperfusion injuries. It was established that prophylactics and timely correction of critical intraoperative hypotenstion that is the main factor of development of postoperative hepatic failure should be considered as the key moments of intraoperative protection of hepatocytes

CHANGES OF BLOOD CYTOKINE LEVELS IN THE COURSE OF DEVELOPING LIVER INSUFFICIENCY AFTER HEPATIC SURGERY

Abstract. The study was carried out in the patients with bulky masses in the liver. Acute hepatic failure was initiated by resection of the liver. In the patients with bulky masses in the liver, increased serum levels of the common cytokines were detected during postoperative period. The blood contents of IL-1β and IL-6 are directly dependent on the surgery-related factors (extent of resection, duration of hepatoduodenal ligation, blood loss volume), that may be employed for prediction of disease course and planning surgical treatment. Determination of a level IL-1β and IL-6 levels is a diagnostic index of liver damage, and it may be used for evaluation of the postresection hepatic failure