The use of endoscopic cryoapplicator in liver and gallbladder surgery

Abstract

Purpose of the study. To investigate the efficacy of focal destruction tissues of local liver diseases, chole- and hemostasis of created endoscopic cryoapplicator in operations on the liver and gallbladder.Material and methods. Review the results of surgical treatment of 121 patients with various diseases of the liver (tumors, alveococcosis, parasitic and non-parasitic cysts) and gallbladder (chronic and acute cholecystitis) using a new endoscopic porous TiNi cryoapplicator. 49 patients were operated by an open method, 72 - laparoscopically. Hemo-and cholestatic control of the instrument was performed intraoperative and in postoperative period - by clinical condition of patient and by ultrasonography. Efficiency of destruction of focal liver diseases was investigated by histological examinations of surgical materials, is confirmed by the absence of relapses in the period from 4 to 6 years.The results. Cryoapplicator is simple in use, in sterilization, no energy consumption, can be used both in open surgery, particularly in arduous regions of the liver and laparoscopic procedures and, most importantly, patients with artificial cardiac pacemakers.Cryodestruction of the liver stump after its resection and the bed of the gallbladder after cholecystectomy reduces blood loss by 30-40%, and also helps to reduce the number of relapses of the disease. There were not observed bleeding and bile leakage in postoperative period. Histological examination proved picture of avascular necrosis, a violation of tissue structure of subjected to destruction liver focal diseases, death of epithelial lining of non-parasitic cysts and membranes of echinococcal cysts. There were not diseases recurrences in the period from 4 to 6 years.Conclusion. Endoscopic porous TiNi cryoapplicator is simple and convenient in use, it has a good hemo- and cholestatic effects, pronounced effect to local destruction of liver focal diseases, can be recommended for open and laparoscopic operations on liver.