Ischemic-reperfusion hepatic injuries in patients after performance of combined resections on pancreatic gland and portal vein


Keywords: pancreatic resection; resection of portal vein; thrombosis of portal vein; acute hepatic insufficiency

Abstract

Objective. Elaboration of the early diagnosis algorithm for thrombosis of the portomesenterial confluens veins in patients after performance of pancreatic resections, соmbined with resection or damage of portal vein and its branches for timely correction of complications developed.

Маterials and methods. Analysis of results of surgical treatment was presented, concerning 269 patients, to whom pancreatic resection of various volume performed, of them in 15 (5.6%) additionally various variants of resection/reconstruction of portal vein with its branches, аnd in 6 (2.2%) patients unintentional damage of the porto-mesenterial confluens veins were noted. Ischemic-reperfusion hepatic damage have been occurred in 17 patients, in 4 patients a portal vein and its branches thrombosis was revealed.

Results. Three degrees of severity of postoperative acute hepatic insufficiency were delineated, basing on estimation of the investigated parameters. Middle and severe degrees of postoperative acute hepatic insufficiency demands essential correction of the intensive therapy conducted. Because of thrombosis of portal vein and its branches 3 of 4 patients died in early postoperative period. Surgical correction of this complication was performed in two patients.

Conclusion. Severe acute hepatic insufficiency may constitute a consequence of thrombosis of a portal vein and its branches, that is why a constant monitoring of passability of the portomesenterial confluens vessels is needed. Revealing of a portal vein thrombosis demands performance of thrombectomy with a portal vein plasty, what gives background to rely on favorable result of treatment.

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Author Biographies


E. V. Mushenko, Zaytsev Institute of General and Urgent Surgery, Kharkov

Mushenko Eugene – Ph.D., Senior Researcher
department of Surgery of Liver and Bile Ducts
V.T. Zaycev Institute of General and Urgent Surgery
61018, Kharkov, V’ezd Balakireva, 1,
057-349-41-50.
dr.mushenko@gmail.com
https://orcid.org/0000-0003-0244-3289


A. M. Tyshchenko, Zaytsev Institute of General and Urgent Surgery, Kharkov

Tyshchenko Olexander – MD., DSci (Med), professor,
Researcher of department of Surgery of Liver and Bile Ducts
V.T. Zaycev Institute of General and Urgent Surgery
61018, Kharkov, V’ezd Balakireva, 1,
057-349-41-20.
prof.amtischenko@gmail.com
https://orcid.org/0000-0003-2357-2055


R. M. Smachylo, Zaytsev Institute of General and Urgent Surgery, Kharkov

Smachylo Rostislav – M.D., DSci (Med), professor,
Head of department of Surgery of Liver and Bile Ducts
V.T. Zaycev Institute of General and Urgent Surgery
61018, Kharkov, V’ezd Balakireva, 1,
057-349-41-20.
rosmachylo@gmail.com
https://orcid.org/0000-0003-1237-0255


T. V. Kozlova, Каrazin Kharkov National University

Kozlova Tatiana – Ph.D., Professor assistant
Department of general and clinical pathology
V. N. Karazin National University.
61000, Kharkov, Svoboda sq. 6.
057-707-56-25.
takovl@ukr.net
https://orcid.org/0000-0003-0432-6967


N. A. Remnyova, Каrazin Kharkov National University

Remnyova Natalia – Ph.D., Associate Professor
Department of general and clinical pathology
V. N. Karazin National University.
61000, Kharkov, Svoboda sq. 6.
057-707-56-25.
remnyova.natalia@gmail.com;
https://orcid.org/0000-0002-6027-2601


E. S. Protsenko, Каrazin Kharkov National University

Protsenko Elena – MD., DSci (Med), Professor,
Head of Department of general and clinical pathology
V. N. Karazin National University.
61000, Kharkov, Svoboda sq. 6.
057-707-56-25.
https://orcid.org/0000-0001-6998-9783


N. N. Honcharova, Kharkov National Medical University

Honcharova Natalia - MD, Ph.D, Associate Professor,
Associate Professor of Department of Surgery №2
Kharkov National Medical University,
61022, Kharkov, 4 Nauky Ave. 4.
057-705-07-11.
drhoncharova@gmail.com;
https://orcid.org/0000-0001-5031-7311

Published
2019-02-27
How to Cite
Mushenko, E. V., Tyshchenko, A. M., Smachylo, R. M., Kozlova, T. V., Remnyova, N. A., Protsenko, E. S., & Honcharova, N. N. (2019). Ischemic-reperfusion hepatic injuries in patients after performance of combined resections on pancreatic gland and portal vein. Klinicheskaia Khirurgiia, 86(2), 17-21. https://doi.org/10.26779/2522-1396.2019.02.17
Section
General Problems of Surgery