SURGICAL TREATMENT OF NON-PARASITAL LIVER CYSTS

Aim of the study: To improve the results of surgical treatment of non-parasitic liver cysts by developing and improving methods of surgical intervention. Materials and methods. When using laparoscopic methods of surgery, the average bed-day was 4.5 ± 1.0, postoperative complication occurred in 1 (1.8%) case. In laparotomy methods, the average bed-day was 12.0 ± 1.5 and 2 (6.3%) cases of postoperative complication, which confirms the benefits of mini-invasive treatment tactics. In the study of long-term results, relapse occurred in 3 (2.9%) cases. Results of the research. Asymptomatic course of the disease certainly complicated the tactics of treatment. Due to the availability of ultrasound examination 78 (88.6%) with non-parasitic liver cysts and 13 (92.9%) patients with polycystic ovary disease knew their diagnosis before the last visit to the hospital, of which 10 (11.4%) patients with non-parasitic liver cysts and 4 (3.9%) with polycystosis are forced to operate due to the development of life-threatening complications. Puncture-aspiration technique with the introduction of sclerosing solutions, which was performed in 23 (26.1%) patients with nonparasitic liver cysts and the method of fenestration - 8 (57.1%) patients with polycystic ovary syndrome, can most likely be attributed to palliative methods. In 2 (2.3%) cases where there were doubts about the non-parasitic nature of cysts, enzyme-linked immunosorbent assay was performed and in 4 (4.5%) patients with suspected malignancy were determined the absence of malignant genesis by tumor markers and morphological examination of the contents of diagnostic cyst puncture. When using laparoscopic methods of operation, the average bed-day was 4.5 ± 1.0, postoperative complication occurred in 1 (1.8%) case, compared with laparotomic methods in which the average bed-day was 12.0 ± 1, 5 and 2 (6.3%) cases of postoperative complication, confirming the benefits of mini-invasive treatment tactics. In the study of long-term results, relapse occurred in 3 (2.9%) cases. Conclusions: 1. In order to prevent the development of dangerous complications of non-parasitic liver cysts and to diagnose them early, it is recommended to use radial examination methods and eliminate them with mini-invasive methods at an early stage of formation. 2. Puncture-aspiration methods of treatment of non-parasitic cysts with external drainage with periodic introduction of sclerosing solutions under ultrasound control are palliative, as evidenced by the presence of relapses (3.4%). Their use is recommended for elderly patients with high comorbidity of concomitant pathology or as a preparatory stage for radical surgery. 3. The use of a mini-invasive method of fenestration of the cysts with deepithelialization of their membranes in polycystic liver is a surgery of choice, which allows to slow the development of hepatocellular insufficiency. 4. The combination of mini-invasive techniques with bipolar coagulation, or laser dissection, or welding electrocoagulation has led to a reduction in complications such as intraoperative bleeding and biliary leakage, and has made it possible to apply them not only to the cystectomy of large complications of cysts, but also to the treatment of complicated cysts. 5. The use of the welding electrocoagulator EC-300M "Swarmed" in laparoscopic cystectomy led to a reduction in the duration of surgery and hospital stay by 2 times, the number of relapses - from 10 to 2.9%.