Background and Aim We prospectively compared the clinical outcomes of radical and conservative surgical procedures for primary liver hydatid cysts, additionally radical surgical procedures with and without the two‐month administration of albendazole after the operation were compared. Methods Overall, 90 patients undergoing open surgical treatment for liver hydatid cysts were divided into three surgical groups: first group, patients who underwent radical surgery (pericystectomy) followed by albendazole treatment for 2 months following the operation group; second group, patients who underwent radical surgery(pericystectomy) without receiving albendazole after surgery group; third group, patients, who underwent conservative surgery (partial cystectomy) with albendazole treatment after surgery. The clinical outcomes and rate of recurrence were analyzed in follow‐up period. Results The mean surgery duration in the Radical groups was significantly longer in comparison to the Conservative surgery + Albendazole group. (212.0 and 202.5 min vs. 173.2 min; p < 0.05). Blood loss in the Radical groups was significantly higher in comparison to the Conservative surgery + Albendazole group (218.3 and 174.6 ml vs. 67.2 ml; p < 0.05). However, postoperative complication rate in the Radical group was significantly lower in comparison to Conservative surgery + Albendazole group (13.3% [n = 4] and 6.7% [n = 2] vs. 36% [n = 11]; p < 0.05). The postoperative hospital stay in both Radical groups was significantly lower in comparison to the Conservative surgery + Albendazole group (7.9 and 7.4 days vs. 11.3 days; p < 0.05). Conclusion In comparison to conservative surgery, radical surgery is a preferable treatment modality for patients with active liver hydatid cysts. Postoperative albendazole treatment is preferable, regardless of the type of surgical procedure.
Ïå÷åíü / Liver Цель. Выявление факторов риска билиарных осложнений после трансплантации печени. Материал и методы. С декабря 2011 г. по сентябрь 2017 г. 85 взрослым пациентам была выполнена трансплантация печени. От живого родственного донора трансплантация выполнена 68 (80%) взрослым пациентам, от посмертного донора-17 (20%). Целая печень пересажена 17 (20%) реципиентам, правая доля от живого родственного донора-60 (70,6%), левая доля-7 (8,2%), задний латеральный сектор-1 (1,2%). Результаты. Билиобилиарный анастомоз сформирован 76 (89,4%) реципиентам, у 13 (17,1%) из них развились билиарные осложнения. Двойной билиобилиарный анастомоз выполнен 5 (5,9%) пациентам, из них у 3 (60%) выявлены билиарные осложнения. Холангиоеюноанастомоз сформирован 2 (2,4%) пациентам, билиарных осложнений не отмечено. При комбинированной билиарной реконструкции (билиобилиарный анастомоз и холангиоеюноанастомоз) из 2 (2,4%) наблюдений в одном был диагностирован стеноз холангиоеюноанастомоза. Заключение. Предоперационные и интраоперационные исследования желчных протоков позволяют планировать вид билиарной реконструкции. Каркасное дренирование желчных протоков при билиобилиарном анастомозе уменьшает число билиарных осложнений.
Goal. Find out the opinion of the Kazakh population about post-mortem organ donation to save the lives of patients with terminal diseases of organs in need of transplantation. Material and methods. The survey was conducted in the form of an anonymous online questionnaire. Our study involved 1176 people, of these, 309 are male and 867 are female. The survey participants were citizens of different regions of the country and different nationalities, the average age of the participants was 38.7±1 years (18-73 years). Results and discussion. 422 participants (36%) agreed to become a posthumous donor, and 644 (55%) refused to donate. 88 (7.6%) of the participants doubted their choice, the other 22 participants did not answer this question. During the survey, out of 1,176 respondents, 991 (84%) participants know that organ transplantation is being carried out in the country, of which 384 (38.7%) participants agree to post-mortem donation, and 607 (61.2%) participants refuse post-mortem donation. 185 (16%) participants are not informed that organ transplantation is being performed in the country, of which 49 (26.5%) participants agree to post-mortem donation, and 136 (73.5%) participants refuse post-mortem donation. As a result, it was found that informed participants agreed to post-mortem donation in 38.7% of cases, and uninformed participants agreed in only 26.5% of cases. Conclusion. For the development of organ transplantation from a cadaveric donor in Kazakhstan, it is necessary to inform the population about organ transplants carried out in large transplant centers of the country, and with good long-term results, to inform the population about the laws of the Republic of Kazakhstan on organ transplantation. It is very important for the population to guarantee security and huge support from the government of the country. In addition, for the development of organ transplantation from a posthumous donor in Kazakhstan, a lot depends not only on the population of the country itself, but also on social, moral, ethical, economic, and humanitarian support from the state government. Organ transplantation from a post-mortem donor is one of the most complex types of medical care, requiring a high level of professional and material support and coordinated actions at all levels of management. This area cannot develop without the support of society, the government, as well as without a positive view of the population. Keywords: organ transplantation, donor, opinion of the population of Kazakhstan.
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