Khirurgicheskoe lechenie pervichnogo i metastaticheskogo raka pecheni

Abstract

Surgical hepatology is presently one of the most intensively developing areas of modern surgery. Success mainly concerns surgical treatment for primary and secondary liver malignancies. The paper presents the immediate and long-term results of surgical treatment in patients with primary and metastatic tumors of the liver. Forty anatomic resections, including 13 via hilar access and 27 via Glissonean approach, were performed in 2005 to 2010. All patients have undergone preoperative comprehensive estimation of hepatic functional reserves since 2008. The magnitude of resection and the volume of intraoperative blood loss significantly affected the degree of postresection hepatic failure. The rate of postoperative complications was lower in the patients operated on via Glissonean approach than in those operated on via hilar approach. The authors' scheme for the preoperative determination of hepatic functional reserves made it possible to predict the development of postresection complications more precisely and to change the scope of surgical intervention in relation to the findings. Surgical approach is essential for the treatment of primary and metastatic tumors of the liver and enables survival rates to be considerably increased.