ANATOMICAL AND EXPERIMENTAL REASONING OF LIVER RESECTION USING HYDRODISSECTION TECHNIQUE

Abstract

Background. Due to an increasing number of liver surgery, the problems of using secure hemostatic techniques during its resection are still relevant and require further study. Objective. To determine the optimal technique of local hemostasis during liver resection based on a comparative morphological assessment of the liver wound. Material and methods. The study was performed on 30 outbred white rats using local hemostatic techniques with further morphological examination of biological material on 7th and 21st days. Results. It has been established that cryohemostasis, electrocoagulation and local application methods of hemostasis are adequate ways to stop blood loss from a wound during liver resection. The analysis of the histological image of micro-preparations showed that the inflammatory response is present in all experiment series, regardless of hemostatic techniques. The disadvantage of using a TachoComb sponge is the need for its fixation to the wound surface, that of a collagen hemostatic sponge – a long period of its resorption, that of electrocoagulation – a damaging effect on liver tissue with marked inflammation. Conclusions. Local cryohemostasis appeared to be the most effective bleeding control technique. Its advantages are the following: it stops bleeding much faster than application techniques; it is characterized by minimal abdominal adhesions; it has a less pronounced damaging effect on liver parenchyma; it facilitates scar tissue formation and it is less likely to cause inflammatory changes in the resection zone.