MORPHOLOGICAL CHANGES IN THE PERIFOCAL ZONE OF LIVER IN ITS HYDATID INJURY

R.M. AGAYEV, R.E. JAFARLI, B.V. MUSAYEV

Azerbaijan Medical University, Baku, AZERBAIJAN

Introduction: Some authors in their studies show that the occurrence of adverse outcomes of surgical treatment of patients with liver echinococcosis (LE) progress in the liver tissue after operative intervention of morphofunctional disorders is very important. No doubt that the above changes affect the postoperative period its regenerative and reparative abilities.

The aim of the study: To evaluate the effectiveness of a combined treatment of ozonized physiological solution of sodium chloride on morphofunctional state of liver in its hydatidinjury.

Materials and methods of study: The present study is based on the analysis of 37 clinical observations of patients treated for LE at the Department of Surgical Gastroenterology of theInstitute of Clinical Medicine named after M.A. Topchubashev for the period from 2008 to 2011. Patients were divided into two groups: Group I consisted of 19 patients whose treatment program was based on the traditional of measures used at the hospital, the II group included 18 patients who in addition to the generally accepted methods, were applied ozone therapy in the complex of therapeutic and preventive measures. Patients of the group wereeverydayinjected pre and post-operative intravenous ozonized physiological solution at a concentration of 4-6mg / l( within 3-5 days).

Results and discussions: The histologic examination of biopsy samples of liver taken from patients in I group found signs of significant changes. Thus, the structure of the pericysticzone of the liver lack typical braced structure, there is expressed polymorphism of liver cells - with different sizes and shapes they are totally much smaller than the “typical hepatocytes”. Studies showed that the use of ozone therapy in a complex treatment of patients with is LEcauses multidirectional changes of subcellular organization of hepatic parenchymal cells: adaptive responses and less destructive processes dominate.

Improvement of the morpho-functional state of liver according to our data correlated with the intensity of reparative processes and the rate of obliteration of the OP in the postoperative period.

FORECASTING RISK FACTORS OF ADVERSE EFFECTS OF SURGICAL TREATMENT OF PATIENTS WITH INJURIES AND CORROSIVE STRICTURES OF BILE DUCTS

B.A. AGAYEV, G.F. MUSLIMOV, G.R. ALIYEVA, T.R. IBRAHIMOV

Scientific Surgical Center named after M.A. Topchubashev, Baku, Azerbaijan

Purpose of the study - to determine prognostic risk factors for adverse effects of surgical treatment in patients with injuries and corrosivestrictures of bile ducts.

Materials and methods: Results of treatment in 60 patients with corrosive strictures and injuries of the bile duct are analysed. For comparative characteristic of the results of treatment, patientstreated in-patiently in 2000-2009 were divided into 2 groups: the control group included 40 (66.7%) patients and the main group included - 20 (33.3%) patients. The majority of patients (39 - 65.0%) were at the age of 30-50 years. Average age of patients was 43 ± 4.8 years (from the age of 15 to 83 years). Ofthem, 51 (85%) werewomen, a 9 (15%) -men. Of 60 patients that underwent surgical treatment for iatrogenic injuries and corrosive strictures of the bile duct, the results of surgical treatment were studied in 51 (85.0%). In the postoperative period, 4 patients (7.8%) died of diseases,not associated with the pathology of the biliary tracts. All the patients had favorable outcome of surgical treatment. Observation of patients who completed treatment (n = 47) lasted 4 - 108 months (average of 42 months).

Results of surgical treatment were excellent in24 (51.1%) of47 patients who completed treatment, andgood in15 (31.9%) patients. Successful outcomes of all the patients constituted 82.9% (37 patients), and the unsuccessful results - 17.1% (8 patients). Analysis of the results of these 8 patients showed that an initial recovery, presence of such signs as cholangitis, jaundice, or outflow of bile, the number of previous operations, and the interval between the last surgery and entrance to the hospital do not significantly affect the long-term result. The most important prognostic factors affecting the results of surgical treatment, were draining of the bile duct, and thenumber of operations in the anamnesis. Since if favorable results after drainage of the bile ducts were observed in 13 (68.4%) patients, the indicator in the group without drainage was 92.9% (26 patients). The same tendency was observed subject to the number of drainage tubes and the time they are in bile duct (p.0.001).

Date: 2014-12-28; view: 902