Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 059] CORRECTION OF POSTOPERATIVE INTRA-ABDOMINAL BLEEDING AFTER SURGERY ON THE LIVER AND BILE TRACT
Farukh MAHMADZODA1, Marufjon BOLTUBOEV1, Davlatmurod SADULLOEV2, Abdurahmon ASHUROV1, Akbar MURODOV3, Faridun SAFAROV2, Islomiddini AZAM2
1Department of Hepatobiliary and Pancreatic Surgery, Avicenna Tajik State Medical University, Tajikistan, 2Department of Hepatobiliary and Pancreatic Surgery, Institute of Gastroenterology of the Republic of Tajikistan, Tajikistan, 3Department of Hepatobiliary and Pancreatic Surgery, Scientific Center of Oncology of the Republic of Tajikistan, Tajikistan
Background : To determine the most optimal tactics for correcting postoperative intra-abdominal bleeding (IAB) in patients after surgery on the liver and biliary tract.
Methods : A retrospective study was carried out on 97 patients who, after operations on the liver and biliary tract, were complicated by postoperative IAB. In 71.1% of cases, bleeding occurred after operations on the liver, in 28.9% - after operations on the biliary tract.
Results : In 15.9% patients, the development of IAB was observed after various types of liver echinococcectomy, and in 44 (63.8%) patients - after various liver resection operations and pericystectomy. In 22.7% cases, bleeding was observed from the liver parenchyma, as well as after ultrasound-controlled opening and drainage of liver abscesses. In 26.8% cases, the source of bleeding was the resected liver stump, and in 21.6% - the residual cavity of the hydatid cyst. IAB after operations on the biliary tract was observed in 64.3% patients after cholecystectomy, in 28.6% after choledocholithotomy, and in 7.1% after the formation of choledochoduodenoanastomosis. Laparoscopy was used in 29 (29.9%) patients for the purpose of diagnosis and treatment of postoperative IAB. At the same time, in 12.4% laparoscopy was transformed into minilaparotomy. Postoperative bleeding was corrected using relaparotomy in 64.9% of cases, which, due to various circumstances, was considered impossible to eliminate bleeding by laparoscopic methods. In 63 cases, relaparotomy was performed with various options for correcting bleeding: suturing the liver stump - 33.3%, coagulation of the liver surface - 30.1%, suturing the residual cavity - 28.6%, suturing the cystic artery - 1.6% and coagulation of the gallbladder bed bubble – 6.3%. In 5.2% of patients, puncture and drainage were performed using ultrasound control. Complications were observed in 5.1% of cases with 4.1% deaths.
Conclusions : The optimal method for choosing the correction of postoperative bleeding is the choice of minimally invasive technologies.
Methods : A retrospective study was carried out on 97 patients who, after operations on the liver and biliary tract, were complicated by postoperative IAB. In 71.1% of cases, bleeding occurred after operations on the liver, in 28.9% - after operations on the biliary tract.
Results : In 15.9% patients, the development of IAB was observed after various types of liver echinococcectomy, and in 44 (63.8%) patients - after various liver resection operations and pericystectomy. In 22.7% cases, bleeding was observed from the liver parenchyma, as well as after ultrasound-controlled opening and drainage of liver abscesses. In 26.8% cases, the source of bleeding was the resected liver stump, and in 21.6% - the residual cavity of the hydatid cyst. IAB after operations on the biliary tract was observed in 64.3% patients after cholecystectomy, in 28.6% after choledocholithotomy, and in 7.1% after the formation of choledochoduodenoanastomosis. Laparoscopy was used in 29 (29.9%) patients for the purpose of diagnosis and treatment of postoperative IAB. At the same time, in 12.4% laparoscopy was transformed into minilaparotomy. Postoperative bleeding was corrected using relaparotomy in 64.9% of cases, which, due to various circumstances, was considered impossible to eliminate bleeding by laparoscopic methods. In 63 cases, relaparotomy was performed with various options for correcting bleeding: suturing the liver stump - 33.3%, coagulation of the liver surface - 30.1%, suturing the residual cavity - 28.6%, suturing the cystic artery - 1.6% and coagulation of the gallbladder bed bubble – 6.3%. In 5.2% of patients, puncture and drainage were performed using ultrasound control. Complications were observed in 5.1% of cases with 4.1% deaths.
Conclusions : The optimal method for choosing the correction of postoperative bleeding is the choice of minimally invasive technologies.
SESSION
E-poster
E-Session 03/21 ALL DAY