[Functional state of liver before and after its resection using various dissection methods]

Today a few randomized investigations have been accomplished, in which advantages and disadvantages of various methods of hepatic resection are compared. The investigation objective was to estimate the hepatic functional state before and after its resection, using various methods of parenchymal dissection. Randomized investigation was conducted in 90 patients, to whom hepatic resection, using scalpel, with its preliminary suturing by the block-like sutures with the Vycril thread, applying radiofrequency coagulator, "clamp crushing" procedure, ultrasonic (Sonoca 300) and a water-jet (Hydrojet) dissectors. The dissection was not combined with the hepatic vessels exclusion. Coefficient of elimination of indocyangreen and a speciphic coefficient of its elimination were estimated. There was established, that putting the block-like sutures and radiofrequency coagulation, concerning the hermetization peculiarities, causes the resection area ischemia, what is accompanied by persisting degradation of hepatocytes and hepatic functional reserve reduction as a result of its resection performance. While the extended hepatic resection conduction it is expedient to apply the methods of ultrasonographic, the jet-like dissection or a "clamp crushing", which guarantee minimization of risk of postoperative hepatic insufficiency occurrence.