EFFICACY OF ONE-STAGE AND TWO-STAGE EXTENSIVE SURGICAL RESECTIONS IN LIVER ECHINOCOCCOSIS

Abstract

Surgery is the main effective way to treat liver echinococcosis. The problem of choosing a surgical technique for treating liver echinococcosis under impaired liver functional reserve and development of post- hepatectomy liver failure remains relevant.
 The aim of the study is to analyze the effectiveness of extensive surgical resections while treating patients with liver echinococcosis.
 Materials and Methods. The article presents the results of surgical treatment of 85 patients with liver echinococcosis from 2006 to 2022. All patient underwent extensive liver resection: 61 patients (71.8 %) were operated on according to one-stage extensive surgical resection protocol; 24 patients (28.2 %) were operated on according to two-stage extensive surgical resection protocol. 
 Results. The applied surgical step-by-step methods for prevention of post-resection liver failure were effective in 24 patients (100 %), Group 2. Three deaths (3.5 %) were recorded in the total mass of the trial patients. Progressive post-resection liver failure was the cause of deaths. After the introduction of a new examination protocol into clinical practice, the authors observed no deaths after extensive surgery resections because of the development of post-resection liver failure. Moreover, no relapses were observed after extensive surgery resections.
 Conclusion. Extensive surgical resections in patients with liver echinococcosis are effective and sufficiently safe when performed in specialized hepatological centers using an in-depth preoperative protocol. Two-stage surgical resections can be recommended in case of initial significant deficit in the volume of the future liver remnant and functional organ reserves.