[Lymph draining surgery in liver cirrhosis complicated by resistant ascites]

Operations in the thoracic duct (TD) were performed in 309 patients with cirrhosis of the liver (CL) complicated by resistant ascites. External drainage of TD (EDTD) was performed in 43 of them, lymphovenous anastomosis (LVA) was created in 166, lymphonodulovenous anastomosis--in 8, ductolysis was performed in 84 patients, simultaneous ligation of left internal jugular vein--in 60, lymphonodulodrainage--in 8. Indications for various lymphodrainage operations are discussed. New modifications of EDTD and LVA extending possibilities of their performing and decreasing the number of failures and complications are proposed. These operations promote reduction of interstitial edema, improvement of intrahepatic microlympho- and microhemocirculation, function of hepatocytes. This permits to eliminate such complications of cirrhosis as ascites and hepatic insufficiency and to prepare patients for subsequent more difficult and more radical interventions.