Over the past ten years, the incidence of cancer of various localization has been steadily increasing, liver neoplasms of both malignant and benign etiology are no exception. The fact remains undeniable that resection remains the radical method of treating liver neoplasms. However, to achieve radical treatment, it is often necessary to perform extended liver resections. Despite this, in some cases, large volumes of resection are not feasible due to the high risk of developing liver failure against the background of a low functional status of the liver, a small volume of the future liver residue. To this end, there are many techniques that allow to carry out a radical volume of the operation, but they all have their drawbacks. In our work, we used the method of minimally invasive, effective and safe prevention of post-resection liver failure. We operated on 36 patients with different etiologies of the disease, with an extremely low volume of remnant, which did not allow safe liver resection. At the first stage, all patients underwent laparoscopic isolation of the portal blood flow of the right lobe of the liver in order to form vicarious hypertrophy of the contralateral lobe of the liver. By the second stage, a sufficient volume of the future liver remnant to perform a safe resection was achieved in 33 cases (91 %). In the subsequent 33 patients, extended liver resection was performed: in 28 (84,8 %) cases, right-sided hemihepatectomy, in 5 (15,2 %) cases, extended right-sided hemihepatectomy. There were no lethal outcomes, post-resection liver failure developed in 3 cases (13 %).
Over the past ten years, the incidence of cancer of various localization has been steadily increasing, liver neoplasms of both malignant and benign etiology are no exception. The fact remains undeniable that resection remains the radical method of treating liver neoplasms. However, to achieve radical treatment, it is often necessary to perform extended liver resections. Despite this, in some cases, large volumes of resection are not feasible due to the high risk of developing liver failure against the background of a low functional status of the liver, a small volume of the future liver residue. To this end, there are many techniques that allow to carry out a radical volume of the operation, but they all have their drawbacks. In our work, we used the method of minimally invasive, effective and safe prevention of post-resection liver failure. We operated on 36 patients with different etiologies of the disease, with an extremely low volume of remnant, which did not allow safe liver resection. At the first stage, all patients underwent laparoscopic isolation of the portal blood flow of the right lobe of the liver in order to form vicarious hypertrophy of the contralateral lobe of the liver. By the second stage, a sufficient volume of the future liver remnant to perform a safe resection was achieved in 33 cases (91 %). In the subsequent 33 patients, extended liver resection was performed: in 28 (84,8 %) cases, right-sided hemihepatectomy, in 5 (15,2 %) cases, extended right-sided hemihepatectomy. There were no lethal outcomes, post-resection liver failure developed in 3 cases (13 %).