The use of laser ablation in the complex treatment of metastatic liver damage.

Abstract

2001), which assess multiple organ failure, were adapted to determine its usefulness. Results: There were 23 men and 11 women (average age 76.8). Frequent underlying pathologies were cardiovascular disease (62%) and diabetes mellitus (24%). 6 patients showed HPVG after abdominal exploration. 3 patients repeatedly experienced HPVG during follow-up. 5 patients experienced diarrhea beforehand. 11 patients died within 28 days after diagnosis and among them, 3 patients underwent ischemic bowel resection. Serum lactate was normal in 17 out of 31 patients measured (55%). Wayne algorithm demonstrated 25 severe, 4 moderate and 5 mild mesenteric ischemia. Among 11 critically ill patients, eight (73%) required vasopressor administration, seven (64%) had abnormal serum lactate level (average 6.1 mmol/L) and base excess (average -9.0 mmol/L). Their average SOFA score was 5.5, whereas non-critical patients were 3.0. HPVG distribution and presence of extra-portal vein gas did not correlate with the clinical condition. Conclusion: HPVG patients with chance of continuous low flow-rate of the gut tend to be lethal. However, most HPVG patients may choose conservative treatment. Unfortunately, Wayne algorithm and SOFA score failed to clarify benign HPVG patient. Further investigation is necessary.