[The repeated operations for focal liver lesions].

Repeated operations for focal liver lesions were analyzed. 75 patients with parasitic liver lesions (alveococcosis, echinococcosis), 14 patients with liver tumors, 15 patients with cysts and abscesses were included in the study. For the first time patients underwent palliative operations or diagnostic laparotomy. In some patients relapse was observed after radical surgery in postoperative period. Ultrasound study was the main diagnostic method for detecting localization and extent of the lesion. 91 patients underwent radical surgery, including hemihepatectomy carried out to 26 patients, segmental and bisegmental liver resections carried out to 35 patients. Transparenchymatous Tung ligation was used in liver resections. Resection line was covered by hemostatic sutures according to B.I. Alperovich technique. Intraparenchymatous processing of Glisson pedicle according to E.I. Galperin method was applied in extensive liver resections. Cryodestruction was used for prophylaxis of relapses in parasitic and tumor lesions. Liver failure (4) and bleedings (2) were the most life-threatening postoperative complications. 4 patients died due to liver failure (2) and bleedings (2). Among 97 patients good results were observed in 73 (75,3%) patients, satisfactory - in 22 (22,7%), poor - in 2 (2,1%) with relapse of hepatocellular carcinoma.

[Ultrasonic diagnosis of complications in repeated surgery of the liver]. / Ul'trazvukovaia diagnostika oslozhnenii pri povtornykh operatsiikh na pecheni.

Ultrasonic examination is an effective noninvasive method in the diagnosis of complications in reoperations on the liver. With the application of the method the cavity of disintegration and sequestration were diagnosed in 86% of patients with complicated alveococcosis. Affection of the elements of the porta hepatis and inferior vena cava was revealed in 82% of patients, which was very important in determining the operability of the process and was of essential significance in planning the volume of liver resection. Right pleuritis, the formation of a residual cavity, and sequestration of the parasitic and hepatic tissue are also diagnosed adequately in the postoperative period by means of ultrasonic examination.

[Hepatectomy in repeated operations on patients with parasitic diseases of the liver]. / Rezektsiia pecheni pri povtornoi operatsii u bol'nykh s parazitarnymi zabolevaniiami pecheni.

The results of resection of the liver in repeated operations on patients with parasitic disease of the liver are discussed. Operations were conducted on 22 patients with alveococcosis and 7 patients with echinococcosis. By means of the method of atypical liver resection radical operations were performed on 20 patients (69%) and palliative resections of the liver in 9 patients (31%). The palliative resections were combined with cryodestruction of the remaining parasitic tissue, which improved the therapeutic effect significantly and prolonged the patients' survival. The volume of the resection ranged from a segment to one half of the liver. The fatality rate was 6.8%.

[Opisthorchiasis of the liver]. / Opistorkhoznye kisti pecheni.

The authors have observed 10 patients with opisthorchiasic cysts of the liver. These cysts are multiple and disposed mainly in the left lobe of the liver. Sonography and laparotomy are expedient methods for diagnosis of the disease. Operations were performed on 7 patients and gave good immediate and long-term results.

[Comparative characteristics of nonparasitic and opisthorchiasis cysts of the liver]. / Sravnitel'naia kharakteristika neparazitarnykh i opistorkhoznykh kist pecheni.

The authors observed 24 patients with opisthorchiasis and 14--with nonparasitic cysts of the liver. No essential differences in the tactics of surgical treatment of these cysts were noted. In medium-size and large cysts, the operative treatment--excision of cystic walls with omentoplasty, liver resection--is recommended; in small opisthorchiasis and nonparasitic cysts--dynamic observation with the performance of ultrasound scanning.

[Repeat surgery of hepatic neoplasms]. / Povtornye operatsii pri novoobrazovaniiakh pecheni.

The paper discusses resection and repeat resection of the liver for tumor carried out at a specialized institution. Combination of resection and cryotherapy for hepatic tumor prevents dissemination of cells thereby improving ablasticity of surgery.