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METHOD FOR PREDICTION AND PREVENTION OF POST-RESECTION ACUTE LIVER FAILURE IN PATIENTS WITH PRIMARY AND METASTATIC LIVER CANCER
METHOD FOR PREDICTION AND PREVENTION OF POST-RESECTION ACUTE LIVER FAILURE IN PATIENTS WITH PRIMARY AND METASTATIC LIVER CANCER
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机译：预防和预防原发性和转移性肝癌患者术后急性肝功能衰竭的方法
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摘要
FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to oncology, hepatobiliary surgery, and concerns the method of preoperative assessment of liver resection volumes in patients with primary and metastatic liver cancer to reduce the incidence of postresection acute liver failure (PROPN). Essence of the method: conduct a comprehensive assessment of the anatomical and functional solvency of the liver parenchyma: CT and/or ultrasound imaging,C-metacetinic respiratory test, ICG test, dynamic liver scintigraphy, and on the basis of the obtained diagnostic data, one of the variants of liver resection is performed: if the remaining volume of the liver is FLR≥30 % and the functional reserve of the liver is not reduced by the results of three tests: KRP≥1.6, R1510, the integral 13CO2 in the exhaled air in the 120minute ≥20 %, then one-stage extensive liver resection is safely feasible: right hemihepatectomy, left-sided hemihepatectomy, extended right-sided hemihepatectomy, extended left-sided hemihepatectomy; if the remaining volume of the liver is FLR≥30 %, but the functional reserve of the liver is reduced by the results of three tests: KRP1.6, R1510, integral 13CO2 in the exhaled air to the 120minute 20 %, then it is necessary to reduce the volume of the operation to segmental resections: bisegmentectomy SVI-SVII, bisegmentectomy SV-SVIII, bisegmentectomy SII-SIII, segmentectomy; if the remaining volume of the liver is insufficient FLR≤30 %, but functional reserve of the liver according to the results of three tests is saved by the IF≥1.6, R1510, the integral 13CO2 in the exhaled air in the 120minute ≥20 %, then a multi-stage liver resection is performed: two-stage liver resection with ligation or embolization of the portal vein, two-stage resection of the liver by type ALPPS or pALPPS – if the remaining liver volume is insufficient FLR≤30 % of the functional liver reserves are reduced by the results of three tests: KRP1.6, R1510, integral 13CO2 in the exhaled air to the 120minute 20 %, palliative techniques are feasible: radiofrequency thermoablation, microwave ablation, laser ablation, cryodestruction.EFFECT: proposed method includes non-invasive examination methods that are safe for the patient, and it allows one to immediately obtain the result according to which the surgical tactics for a particular patient should be adjusted.1 cl, 2 ex, 1 dwg
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