[Functional reserve in benign volumetric lesions]

For evaluation of functional status of hepatocytes in patients with benign volumetric growths of the liver (BVGL) of various genesis the authors performed radionuclide investigation with the use of Tc99m. At the same time the terms of maximal accumulation of the preparation Tmax' the period of half elimination from the liver (T1/2) and the time of entering of the drug into the bowel (T bowel) were evaluated. Basing on the results of the analysis of clinical examinations in 67 patients before and after operations (51 patients with BVGL and 16 patients of control group), the authors have revealed correlation between the size, site disposition of volumetric growth and function of hepatocytes of intact parenchyma of the liver. The results have evidenced that the rate of decrease in functional values of the liver in groups of patients with BVGL < 5 and > 5 cm in diameter significantly (p < 0.05) differed in parameters Tmax (33.3 and 78.3%) and T1/2 (50 and 95.7% of cases, respectively. It has been determined that the more is the size of the growth and the deeper it located in hepatic parenchyma the more significant is the decrease of function of hepatocytes. Comparison of the results of examination in patients with BVGL of various genesis before and after various surgical intervention of decompressive type has revealed significant (p < 0.05) improvement of functional capacity of hepatocytes, depending on the above factors. The results of investigation made it possible to substantiate differential approach to surgical policy in uncomplicated BVGL depending on the size of the tumor (< 5 and > 5 cm in d.), location and position of the growth in the organ, as well as adequately evaluate effectiveness of surgical intervention.