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- 검색키워드
- 저자 : ( Abai Baigenzhin ) (검색결과 2 건)
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Self-Experience of Surgical Management of Bile Duct Strictures after Liver Transplantation
( Yerkin Turdiyev ),( Marlen Doskali ),( Abai Baigenzhin ),( Zhaksylyk Doskaliyev ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Bile duct (BD) stricture is one of the most common complication following liver transplant surgery and its challenging clinical condition requires a multidisciplinary approach for management. Methods: We analyzed the outcome of 6 patients who hospitalized in our center with BD strictures and underwent traditional surgery. In all patients biliary strictures are associated with a broad spectrum of signs and symptoms, ranging from subclinical disease with mild elevation of liver enzymes to complete obstruction with jaundice, itching and cholangitis. Results: Traditional reconstructive surgery on bile duct remains as the mainstay of treatment, even it is associated with significant morbidity and variable long-term outcome. In our center an outcome of surgical management depended on both the etiology and location of stricture. Our data shows successful long-term results in patients with conventional surgery on BD. Conclusions: In conclusion, bile duct strictures often due to surgical inexperience, failure to recognize abnormal biliary anatomy and congenital anomalies, misplacement of clips, excessive use of cautery, and excessive dissection around the major bile ducts. Surgeons should be confident to avoid these causes and minimize an ischemic injury of BD.
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Experience of Managment of Large Liver Hemangiomas
( Aidos Kulmagambetov ),( Marlen Doskali ),( Zhaksylyk Doskaliyev ),( Abai Baigenzhin ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Hepatic hemangiomas are benign tumors, and they are usually asymptomatic with normal liver function. The aim of this study was to find applicable solutions for patients with large hepatic hemangiomas due to detailed observation of tu mor diameter and liver function. Methods: In our study we retrospectively reviewed the patient charts of 21 patients with large hepatic hemangiomas treated with several methods at National Scientific Medical Research Center, Astana. Clinical Features: - The commonest liver tumor - 5% of autopsies - Usually single small - Well demarcated capsule - Usually asymptomatic Results: The median age was 41 years (37-51) and 85% were female. The median hemangioma size was 6.5 cm (6-12.1). Abdominal ultrasound was conclusive in 66.7% (13/21) and four-phase computed tomography (CT) in 82.6% (17/21) of pa tients. The indication for treatment was progressive abdominal pain in 78.6% (18/21). All patients were observed and showed no complications related to the liver hemangioma during fol low-up. A large hemangioma resection - 3 cases - safely per formed at highly specialized surgeon. The main indication for surgical procedures remains abdominal pain symptoms. Both surgical resection, enucleation and TAE are safe and are well admitted by patients. Conclusions: Surgical resection and surgical enucleating are the treatments of choice in the management of hepatic hemangio mas. In recent period transcatheter arterial embolization (TAE) has become as routine method to manage tumor growth. However, we use definition as large hemangiomas when he patic tumors reach 4 cm.
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