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RISS 인기검색어
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- 저자 : ( Aidos Kulmagambetov (검색결과 2 건)
- 무료
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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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Liver Transplantation for Patient with Emergency Indication
( Aidos Kulmagambetov,),( Marlen Doskali,),( Zhaksylyk Doskaliyev ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Decompensate liver cirrhosis is often accompanied by hepatorenal syndrome (HRS) with mortality up to 80%. The aim is improving the results of critical cases of decompensate liver cirrhosis in terminal phase. Methods: Patient S., 32 years old, female, enrolled with decompensated Primary Liver Cirrhosis, Child-Pugh class C, portal hypertension, esophageal varices II degree, ascites and hydrothorax, secondary coagulopathy and hepatic encephalopathy - III. MELD was 38. In inpatient ward his condition become worse as marked dyspnea, itching, ascites, oliguria. The total bilirubin increasedto critical levels (571 mcmol/L), hepatocellular, kidney (Cre 220mcmol/L) and respiratory failure progression and growing of ascites tense. MARS-therapy was ineffective. Despite significant coagulopathy, the continuous renal replacement procedure was performed safely and without incident. Cadaveric donor liver transplantation was indicated and performed by standard method. Results: In postoperative period intensive care and triple immunosuppression therapy (calcineurin inhibitor started on the 4th day, because of HRS) were done. In our patient, our treatment strategy resulted in resolution of ascites and edema, and improvement of renal function and hemodynamics. Patient discharged after 42 days after transplantation operation. Conclusions: Thus, in this emergency case just organized and undertaken by highly qualified emergency medical care to a patient in a terminal state would save lives.
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