Postoperative hepatic insufficiency as a cause of mortality in patients with giant complicated hydatic cysts

Abstract

Introduction Giant hydatid cysts usually lead to diffuse irreversible damage to the liver, aggravating the results of surgical treatment and their presence is accompanied by high mortality. Purpose analysis of factors that predispose to the development of liver failure in patients with complicated echinococcosis Material and methods 347 patients with hepatic hedadidosis were operated on in the clinic between 2000 and 2020. The diagnostic algorithm included: USG, Doppler, EFGDS, CT, MRT in cholangiography, serological and biochemical analyzes. Results In 33 (9.5%) cases, giant hydatid cysts located in more than 4 segments of the liver were detected. Of which, in the preoperative period, liver cirrhosis was detected in 4 (12.1%) patients, the early stage of portal hypertension was detected in 7 (21.2%), mechanical jaundice in 9 (27.3%), reactive hepatitis in 10 ( 30.3%) patients, hydatid cachexia in 4 (12.1%). Postoperative liver failure developed in 9 (27.3%) patients who underwent urgent surgery. Mortality rate - 7 (18.1%). Conclusions Predisposing factors for the development of postoperative liver failure are as follows - large destructive lesions of the liver parenchyma, small volume of the remaining parenchyma, decreased blood supply, cachexia, old age, the presence of concomitant pathologies.