Вплив ендоваскулярної підготовки на результати хірургічного лікування поширених гемангіом печінки

Abstract

Objective – to study the effectiveness of preoperative portal vein branches embolization (PVE) in patients with advanced liver hemangiomas in the complex of preparation of these patients for radical liver resection. Materials and methods. PVE was performed in 67 patients with liver hemangiomas, the volume of the future liver remnant in which was less than 20 % of intact liver parenchyma. Laboratory parameters were studied before PVE, on day 5 after the intervention and immediately before liver resection. Hypertrophy of the future liver remnant was assessed by comparing computer tomography data before PVE and before resection. Results. In patients after PVE, an increase in the future liver remnant by 57.0 % was observed, which allowed 62 (92.5 %) patients to be included in the operable group. A significant increase of aminotransferases and decrease of blood albumin and protein on day 5 after PVE and their return before resection of the liver to baseline values was observed. This indicates an increase in cytolysis processes and a decrease in the synthetic function of the liver immediately after endovascular intervention. Restoration of the hepatic tissue occurs for 3 weeks. Conclusions. In patients with advanced liver hemangiomas who are candidates for liver resection, PVE is an effective minimally invasive technique for reducing the risk of postoperative complications associated with a small liver remnant.