Liver resections and operations in portal hypertension viewed via the experience of our practice]

After listing the indications for liver resection, the operative technique used is discussed with a special reference to an original modification implemented in practice. The case material is made of 52 liver resections and 6 lobectomies with a favourable outcome. In one lobectomy with subtotal proximal resection jejunogastroplasty is performed, supplemented by isolated antireflux anisoperistaltically interposed invagination esophagojejunostomy, duplicated by suturing its two portions. Application of catheter, inserted into the recanalized umbilical vein, is described under the heading of locoregional chemotherapy. In carcinomas involving the confluence of hepatic ducts a variant of Rodney Smith's operation is used while in hepatocholedochus resection plastic repair is done over Kerr drainage. In portal hypertension, after discussing the various methods existing, attention is called to the indirect shunts: splenectomy with omentoreno- and omentoparietopexy, Charsky and fenestration of Glisson's capsule using electric knife and argon with omentohepato- and hepatoparietopexy, as well as implantation of the recanalized v. umbilicalis into m. rectus abdominis dexter. In 15 cases operated on by parenchyma stimulating procedures, survivorship ranging from 3 to 26 years is achieved. For the purpose of prophylaxis against cholangiohepatitis and cirrhosis the following operations are performed: 68 papillotomies and plastic repairs over balloon catheter, passed through the choledochus and papilla, using an electric knife, 12 choledochoduodenostomies type "frog mouth", and 11 deperitonizations-desympathizations with a successful cure being attained.