Prognostic significance of application the non-invasive method of evaluating the functional state of residual parencheme of the liver in patients with focal liver education

Abstract

The aim of the study was a determination of the prognostic significance of a non-invasive preoperative assessment to evaluate the functional state of residual liver parenchyma in order to prevent the development of acute hepatic failure.
 76 patients with focal liver formation were examined. The first group included 46 patients, who were examined using the method of a non-invasive preoperative assessment of the functional state of residual liver parenchyma, which developed by the authors. The definition of the "resectional index" (IR) was made using the following formula: IR = Vint / TP (U), where Vint - the volume of intact liver parenchyma (cm3); TP - total protein of blood serum (g /l). The second group consisted of 30 patients, whose results of surgical treatment were analyzed retrospectively. Major hepatic resections were performed in 26 (56.52%) patients in the primary and 20 (66.67%) in the control group. The study conducted a comparative intergroup analysis of the frequency and severity of developing complications in the study groups. The complications were distributed according to the Dindo-Clavien classification scale, according to which the life-threatening complication rate was 8.7% and 26.67%, severe postoperative hepatic-cell insufficiency was detected in 2.17% and 16.67% of patients in the main and control group. The differences were statistically significant. It was defined value of the "resectional index" (more than 20 U), the excessing of which statistically significantly increased the risk of severe postoperative complications, in particular acute hepatic failure.