[An experience with 100 cadaveric transplantations of the liver in the Russian Research Center of Radiology and Surgical Technologies].

The authors made an analysis of their first 100 transplantations of cadaveric liver made at the period from 1998 through 2011. Postoperative complications and long-term results of transplantations at the period to 13 years are described. Cumulative survival up to 12 months was 91%, to 36 months--83%. Retransplantation of the liver was performed on 5 patients, 2 of them being successful.

[The value of intraoperative Doppler-flowmetry in assessment of blood flow after the hepatic artery reconstruction during the orthotopic liver transplantation].

The practical relevance of volumetric blood flow in the hepatic artery during orthotopic liver transplantation was determined. From May 2009 to January 2011 25 patients underwent orthotopic liver transplantation. Volumetric blood flow in the hepatic artery is routinely measured using a Doppler flow meter during the operation. In 15 cases out of 25 (60%) the blood flow rate immediately after the formation of arterial anastomosis was 150 ml/min (190 +/- 40 ml/min) and increased to adequate with repeated measurements. In 2 cases out of 25 (8%) the blood flow rate reduced in repeated measurements, but by the end of operation the blood flow to the hepatic artery was at the satisfactory level. Blood flow less than 150ml/min immediately after the formation of arterial anastomosis was found in 8 cases out of 25 (32%). The cause of inadequate blood flow was identified and corrected. There were no cases of hepatic artery thrombosis at the early postoperative period. The routine use of intraoperative blood flow measurements allows timely determination of insufficient arterial blood supply of the transplant and elimination of its causes.

[Roentgenoendovascular hemostasis of arterial bleeding after major surgery for pancreatic cancer].

The efficacy of angiographic hemostasis in cases of massive arterial bleeding after major pancreatic resection was evaluated. Late life-threatening arterial hemorrhage developed in 3 out of 65 patients (4.6%) within 12, 20 and 42 days after pancreatic carcinoma resection. In all cases emergency roentgenoendovascular procedures were fulfilled for hemostasis. Six therapeutic angiographic procedures (from one to three per a patient) were performed. All of them were clinically and technically successful. Depending on the bleeding localization and the character of vascular lesion, the embolization (n = 5) or stent-grafting (n = 1) were used. The further prognosis was dependent on the success of treatment of complications and the course of the malignant disease. The emergency angiography with endovascular hemostasis appears to be the method of choice in treatment of postoperative visceral bleedings especially in patients with high surgical risk.

[Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion in the combined treatment of pancreatic cancer].

Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion with gemicitabine was administered to 28 patients with operable exocrine pancreatic cancer. It was well tolerated and not followed by complications which allowed for gastropancreatoduodenal resection to be carried out in all cases. Complete course of combined treatment was given to 23 out of 28 patients (82.1%). As a result, 2-, 3- and 5-year actuarial survival rates were 23.9, 17.4 and 13%, respectively. Long-term survival was recorded among patients without metastases into regional lymph nodes: two of them have survived without relapse for more than 5 years and one died of tumor progression after 4 years of the follow-up.