Issue: 2022, Vol. 27, No. 4

А. О. Krasnov, V. V. Anishchenko, К. А. Krasnov, V. А. Pelts, О. А. Krasnov, V. V. Pavlenko

SMALL ANATOMICAL RESECTION TECHNIQUES IN THE TREATMENT FOR LIVER ECHINOCOCCOSIS

Keywords

liver echinococcosis, small anatomical resection, laparoscopic techniques

Abstarct

Objective – to evaluate the results of the treatment for patients with liver echinococcosis (LE) by the application of small anatomical resections and modern laparoscopic techniques. Material and methods. 26 patients (8 men and 18 women) who undergone the operations for LE in the surgical unit №2 of the Kuzbass emergency hospital named after M.A.Podgorbunsky (city of Kemerovo) were enrolled in the study. Small anatomical liver resection was performed in all patients: in 19 – by laparoscopic access (1 group), in 7 – laparoscopically (2 group). Results and discussion. The performing of small anatomical liver resections by laparoscopic interventions was accompanied by the increasing the duration of the operation (221,4 ± 30,2 min, in 1 group – 151,6 ± 23,0 min, р < 0,05), which was stipulated by the dissection of parenchyma which required additional time (115 ± 28 min, in 1 group – 49,5 ± 20,0 min, р < 0,05). In the second group the Pringle maneuver was used in 5 of 7 cases; it was accompanied by hemostasis duration increase but significantly reduced the volume of blood loss in comparison to those cases when it was not used. In laparoscopic interventions the application of Floseal hemostatic matrix resulted in faster hemostasis. The complications in postoperative period were registered in 1 group only: in one case – suppuration of postoperative sutures and right-sided pleurisy in another case. Average patient’s stay in bed in the first group was amounting to 7,3 ± 1,9 days, in the second group – 4,6 ± 1,3 days (p < 0,05). Conclusion. Laparoscopic resection techniques in the treatment of LE allowed to achieve good intermediate and long-term results, and had several advantages: reducing access injury, decreasing the number of postoperative complications and cutting duration of patient stay in hospital.

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