HIDDEN HEPATIC FAILURE DURING SPACE-OCCUPYING LIVER LESIONS

Abstract

Aim. Early diagnosis, prognosis and prevention of hepatic failure during surgical treatment of spaceoccupying liver lesions.

Materials and methods. 64 patients having space-occupying liver lesions were observed. Subjects of research consisted of 52 (81,2%) man and 12 (18,8%) women of the 26-74 age range. To diagnose depression of liver cells during space-occupying liver lesions in a tissue, histochemical methods revealing the content of Nicotinamide adenine dinucleotide (NAD), Nicotinamide adenine dinucleotide phosphate (NADPH), Xanthine oxidase (XO), Malondialdehyde (MDA), Conjugated dienes (CD) with Sukhopar method (1989) were used. To prevent and treat hidden hepatic failure in the early post-operation period, patients of the main group received anti-hypoxic, anti-oxidant therapy with Reamberin 800,0-1,5% solution with liver metabolism inducing drugs during 5-6 days before and after the operation.

Results. In postoperative period 3 patients of the main group had complications in a form of cholestasis (2), subhepatic abscess (1) that required opening and drainage. There were no lethal outcomes. Patients of the control group in 7 cases had complications like the hepatic failure (4), post operation subdiaphragmatic abscess (2) and small intestine fistula with 4 lethal outcomes.

Conclusion. Adequate infusion therapy with Reamberin, liver metabolism inducing drugs, adequate anesthesia and careful surgery of space-occupying liver lesions before the operation can significantly reduce hepatic failure.