LIVER TRANSPLANTATION AND LIVER RESECTION WITH VASCULAR RECONSTRUCTION FOR ADVANCED ALVEOCOCCOSIS
https://doi.org/10.16931/1995-5464.2016211-24
Abstract
Aim. To study the results of liver transplantations and resections with vascular reconstruction for advanced alveococcosis.
Material and Methods. The retrospective study included 21 patients with alveococcosis and lesion of more than 5 segments and (or) a parasitic invasion into portal vein bifurcation and (or) inferior vena cava, and (or) hepaticocaval confluence.
Results. Liver resection was performed in 9 (42.9%) patients (group 1) if preserving or reconstruction of afferent and (or) efferent venous bed of remaining liver part was technically feasible. Hypothermic perfusion in vivo in situ was used in 1 case, portal vein reconstruction — in 5 cases, inferior vena cava reconstruction — in 8 patients, arterial reconstruction — in 1 patient. Transplantation was performed in 12 (57.1%) patients (group 2). There were 6 patients with liver cirrhosis and 1 patient with Budd-Chiari syndrome. The whole liver from postmortem donors was transplanted to 7 recipients, right liver half from living related donors — to 5 patients. Inferior vena cava resection was performed in 10 cases. Hospital mortality was absent. Median recurrence-free follow-up was 17 months. Overall 1- and 3-year survival was 100% and 89%, respectively (p = 0.617).
Conclusion. Radical treatment of advanced liver alveococcosis is feasible in the most of patients if unresectable distant metastases are absent and initial surgical tactics is correct. Interventions should be performed in specialized centers where resections and transplantations are routinely performed.
About the Authors
I. A. Porshennikov
State Novosibirsk Regional Clinical Hospital;
Novosibirsk State Medical University
Russian Federation
Russian Federation
Porshennikov Ivan Anatolievich — Cand. of Med. Sci., Deputy Chief Physician for Surgical Care, State Novosibirsk Regional Clinical Hospital; Assistant Professor at the Chair of Hospital and Pediatric Surgery, Novosibirsk State Medical University
For correspondence: Porshennikov Ivan Anatolievich — 130, Nemirovicha-Danchenko str., Novosibirsk, 630087, Russian Federation
A. Yu. Bykov
State Novosibirsk Regional Clinical Hospital
Russian Federation
Bykov Alexander Yurievich — Head of the Organ Transplantation Department
Russian Federation
Bykov Alexander Yurievich — Head of the Organ Transplantation Department
V. N. Pavlik
State Novosibirsk Regional Clinical Hospital
Russian Federation
Pavlik Vladimir Nikolaevich — Surgeon at the Organ Transplantation Department
Russian Federation
Pavlik Vladimir Nikolaevich — Surgeon at the Organ Transplantation Department
A. S. Kartashov
State Novosibirsk Regional Clinical Hospital
Russian Federation
Kartashov Alexey Sergeevich — Surgeon at the Organ Transplantation Department
Russian Federation
Kartashov Alexey Sergeevich — Surgeon at the Organ Transplantation Department
E. E. Shchekina
State Novosibirsk Regional Clinical Hospital
Russian Federation
Shchekina Elena Evgenienva — Surgeon at the Organ Transplantation Department
Russian Federation
Shchekina Elena Evgenienva — Surgeon at the Organ Transplantation Department
M. A. Korobeynikova
State Novosibirsk Regional Clinical Hospital
Russian Federation
Korobeynikova Maria Alexandrovna — Surgeon at the Organ Transplantation Department
Russian Federation
Korobeynikova Maria Alexandrovna — Surgeon at the Organ Transplantation Department
E. G. Yushina
State Novosibirsk Regional Clinical Hospital
Russian Federation
Yushina Ekaterina Gennadievna — Surgeon at the Organ Transplantation Department
Russian Federation
Yushina Ekaterina Gennadievna — Surgeon at the Organ Transplantation Department
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Review
For citations:
Porshennikov I.A., Bykov A.Yu., Pavlik V.N., Kartashov A.S., Shchekina E.E., Korobeynikova M.A., Yushina E.G. LIVER TRANSPLANTATION AND LIVER RESECTION WITH VASCULAR RECONSTRUCTION FOR ADVANCED ALVEOCOCCOSIS. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2016;21(2):11-24. (In Russ.) https://doi.org/10.16931/1995-5464.2016211-24
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