Novosti
Khirurgii

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Year 2019 Vol. 27 No 4

GENERAL & SPECIAL SURGERY

V.V. BOYKO 1, V.A. VOVK 2

USE OF MINIMALLY INVASIVE INTERVENTIONS IN TREATMENT OF CHOLANGIOGENIC LIVER ABSCESSES

V.T. Zaycev Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine 1,
Kharkiv Regional Clinical Hospital 2, Kharkiv,
Ukraine

Objective. To improve surgical treatment of patients with the liver cholangiogenic abscesses of liver through the introduction of minimally invasive technologies.
Methods. In the proposed study the treatment results of 49 patients with biliary liver abscesses are presented. There were 31 women and 18 men aged 37 to 69 years. Surgical interventions for hepatic abscesses were performed simultaneously with the elimination of the primary pathological process of the biliary system, which caused the occurrence of cholangitis or in the near future (up to 3 days) after biliary drainage.
Results. Drainage under ultrasound guidance was performed in 21 patients with single and 7 patients with two or more cholangiogenic liver abscesses. At the same time, liver abscess and bile duct were drained in 8 patients in the x-ray operating room. Laparoscopic interventions were performed in 21 patients.
Among the patients operated on using minimally invasive technologies, 7 complications (14.3%) developed: 2 patients had bile leakage, 1 had the right-side hydrothorax, 1 had the right-side pleural empyema, 1 had the postoperative wound suppuration, and 2 had remaining stones in the common bile duct. One patient died (2.0%) due to the development of biliary sepsis with the obstruction of the biliary tract of malignant etiology.
Conclusions. Percutaneous drainage of liver abscesses under ultrasound control is appropriate not only for single abscesses, but also for their larger number. The possibility of simultaneous drainage of liver abscess and bile duct was proved. Percutaneous drainage of the liver abscess, drainage of the biliary tract and laparoscopic surgical intervention are complementary components of minimally invasive surgery in the treatment of the biliary origin liver abscesses. In case of localization of abscesses in the marginal segments of the liver, a laparoscopic atypical resection of the liver with an abscess is most desirable.

Keywords: liver abscess, cholangitis, minimally invasive surgical procedure,biliary drainage, liver abscess drainage
p. 386-393 of the original issue
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Address for correspondence:
61022, Ukraine,
Kharkiv, Nezalezhnosti Ave., 13,
Kharkiv Regional Clinical Hospital,
Surgical Unit.
Tel. +38(050)924-61-56,
e-mail: valery_vals@ukr.net,
Valerii A. Vovk
Information about the authors:
Boyko Valery V., Corresponding Member of National Academy of Medical Sciences of Ukraine, MD, Professor, Director of the V.T. Zaycev Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine.
https://orcid.org/0000-0001-8675-2702
Vovk Valerii A., PhD, Associate Professor, Surgeon of the Surgical Unit, Kharkiv Regional Clinical Hospital, Kharkiv, Ukraine.
https://orcid.org/0000-0003-0888-1837
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