THE USE OF A NON-INVASIVE METHOD FOR ASSESSING THE FUNCTIONAL STATE OF RESIDUAL LIVER PARENCHYMA IN PATIENTS WITH MALIGNANT NEOPLASM OF THE LIVER

Аim. The aim of the study was a determination the effectiveness of a non-invasive preoperative assessment to evaluate the functional state of residual liver parenchyma in order to prevent the development of acute hepatic failure. Materials and methods. Were examined 51 patients with malignant neoplasms of the liver. In the main group included 31 patients, who were examined using the method of a non-invasive preoperative assessment of the functional state of residual liver parenchyma, which developed by the authors. The definition of the «resectional index» (IR) was made using the following formula: IR=Vint/TP (U), where Vint – the volume of intact liver parenchyma (cm3); TP – total protein of blood serum (g/l). The group of control consisted 20 patients, whose results of surgical treatment were analyzed retrospectively based on «statistical card of the patient leaving hospital». The present sample was representative, studied groups were comparable in all indicators. Results. The study conducted a comparative intergroup analysis of the frequency and severity of developing complications in the study groups. The complications were distributed according to the Dindo-Clavien classification scale, according to which the life-threatening complications rate were 12.9% and 40.0%, medium-heavy – 3.23% и 10.0% respectively for main and control groups, what was statistically significantly for the life-threatening complications with the value of the «resectional index» more than 20 U (р=0,004). Severe postoperative hepatic-cell insufficiency was detected in 3.23% и 25.0% of patients in the main and control group. The differences were statistically significant (р=0.0288). In assessing the follow of postoperative period were examined the levels of marker laboratory indicators, reflecting the change in biosynthetic function of the liver, conjugated excretion, presents of necrosis of the hepatic parenchyma. The revealed differences are statistically significant for the levels of total bilirubin of blood plasma (p<0.00524), ALT (p<0.003676), albumin of blood plasma (р<0.00575). Conclusions. Was shown a high efficiency of a non-invasive preoperative assessment to evaluate the functional state of residual liver parenchyma in order to prevent the development of acute hepatic failure. Was defined value of the «resectional index» the excessing of which statistically significantly increased the risk of severe postoperative complications. The application of the «resectional index» may be recommended in order to forecast development of acute hepatic failure when planning treatment of patients with malignant neoplasms of the liver.