Hybrid Technology in Determining of Functioning Volume Liver Before Major Resection
Abstract
Aim: reduce the percentage of acute post-resection liver failure after major resection. Material and methods. From January 2013 patients who planned removal of more than 3 segments of the liver, in addition use computer liver volumetry used SPECT / CT of the liver with the definition of the scope and location of the pre-emptive functioning liver parenchyma on lobes. Identified two groups of patients. The first group included patients (n = 15) who were treated with up to January 2013 (SPECT/CT of the liver was not used), all patients in the first phase was completed preliminary portal vein embolisation (PVE). The second group included patients (n = 9), which, depending on the data of CT volumetry and the presence of precipitating factors to apply differential treatment when interpreting the data SPECT / CT. Results. In the first group of radical surgery in 9 patients. Acute postoperative hepatic failure occurred in one patient, who was stopped on a background of conservative therapy (Class A). In the second group of patients based on the results of pre FLR volumetry ranged from 25 to 35%. In 5 patients, the amount of functioning liver parenchyma in the FLR was 30% or more, they performed a liver resection: RHHE - 2 ERHHE - 2. In 4 patients the amount of functioning parenchyma in the remaining part was less than 30% of these patients has been applied a two-step method of treatment. Radical surgery in 3 patients: RHHE - 2 ERHHE - 1. Signs of acute post-resection liver failure in this group of patients was not. Conclusion. Patients with borderline FLR application of SPECT/CT allows differentiated liver choose the tactics of treatment and thereby reduce the likelihood of developing post-resection of acute liver failure, reduce postoperative mortality and improve treatment outcomes in this group of patients.
About the Authors
Alexei Vasilevich Shabunin
The Russian Academia for Post-Graduate Education; S.P. Botkin City Clinical Hospital
Russian Federation
Russian Federation
Anatoly Vasilievich Karalkin
N.I. Pirogov City Clinical Hospital №1
Russian Federation
Russian Federation
Dmitry Nikolaevich Grekov
The Russian Academia for Post-Graduate Education; S.P. Botkin City Clinical Hospital
Russian Federation
Russian Federation
Pavel Alexeevich Drozdov
S.P. Botkin City Clinical Hospital
Russian Federation
Russian Federation
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Review
For citations:
Shabunin A.V., Karalkin A.V., Grekov D.N., Drozdov P.A. Hybrid Technology in Determining of Functioning Volume Liver Before Major Resection. Medical Visualization. 2015;(4):39-45. (In Russ.)
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