Fast track pathway for patients undergoing liver resection for colorectal cancer metastases

Abstract

Aim: Reduce the percentage of acute post-resection liver failure after major resection. Material and methods: Identified two groups of patients. The first group included 15 patients, who were treated with up to January 2013 (SPECT/CT of the liver was not used), all patients in the first phase was completed preliminary portal vein embolisation (PVE). The second group included 9 patients, which, depending on the data of CT volumetry and the presence of precipitating factors to apply differential treatment when interpreting the data SPECT / CT. Results: In the first group of radical surgery in 9 patients. Acute postoperative hepatic failure occurred in one patient, who was stopped on a background of conservative therapy. In the second group of patients based on the results of pre FLR volumetry ranged from 25 to 35%. In 5 patients, the amount of functioning liver parenchyma in the FLR was 30% or more, they performed a four liver resection. In 4 patients the amount of functioning parenchyma in the remaining part was less than 30% of these patients has been applied a two-step method of treatment. Radical surgery in 3 patients: RHHE e 2 ERHHE e 1. Signs of acute postresection liver failure in this group of patients was not. Conclusion: Patients with borderline FLR application of SPECT/CT allows differentiated liver choose the tactics of treatment and thereby reduce the likelihood of developing post-resection of acute liver failure, reduce postoperative mortality and improve treatment outcomes in this group of patients.