Synchronous liver metastases (SLMs) are found in 15%e25% of patients at the time the presentation with colorectal cancer, which is limited to the liver in 30%. Surgical resection is the most effective and potential curative therapy for metastatic colorectal carcinoma (CRC) to the liver. Simultaneous resection of primary CRC and synchronous liver metastases is subject of debate with respect to morbidity in comparison to staged resection. Minimally invasive laparoscopic surgery improves postoperative recovery, diminishes postoperative pain, reduces wound infections, shortens hospitalization, and yields superior cosmetic results, without compromising oncological outcome. The aim of this study is therefore to evaluate our initial experiences of simultaneous laparoscopic resection of primary CRC and SLM. Methods: Currently, laparoscopic resection of primary CRC is performed in more than 53% of all patients in our surgical department. 18 patients with primary CRC and a clinical diagnosis of SLM underwent combined laparoscopic colorectal and liver surgery. 6 of them underwent laparoscopic colorectal resection combine by major laparoscopic liver resection. Results: Surgical approach was total laparoscopic (17 patients) or hand-assisted laparoscopic (1 patients). The incision created for the extraction of the specimen varied between 5 and 8cm. Median operation time was 245 (range 150e320) minutes with a total blood loss of 600 (range 200-750) ml. Postoperative hospital stay was 7day (5e12). An R0 resection was achieved in all patients. Conclusions: Simultaneous laparoscopic colorectal and liver resection appears to be save and feasible in selected patients with CRC and SLM, with satisfying short-term results.

Objective. To estimate the results of operative treatment of hepatic alveococcosis in conditions of surgical centre of non-endemic region. Materials and methods. From 2004 to 2020 yr in Department of Transplantation and Hepatic Surgery of Shalimov National Institute of Surgery and Transplantation NAMS of Ukraine 13 patients, suffering hepatic alveococcosis, were radically operated. General characteristic of patients, methods of preoperative preparation, іntraoperative data, the indices of morbidity and lethality were investigated. Results. In 11 (84.6%) patients the disease was diagnosed on late stages: IIIa-IV in accordance to pTNM by WHO classification. Preoperatively in 5 (38.5%) patients transcutaneous transhepatic cholangiostomy and in 8 (615%) patients - roentgenendovascular occlusion of the portal hepatic vein branches - were performed. In 12 (92.3%) patients extended hepatic resections were done, including in 2 (15.3%) - complete vascular hepatic exclusion with hyperthermic perfusion in situ. Postoperative complications rate of IIIa-IV degrees in accordance to Clavien-Dindo classification have constituted 30.7%, while postoperative mortality - 7.7%. Up to the end of follow-up the disease-free period have persisted in all the patients. Conclusion. Aggressive surgical tactics in patients, suffering hepatic alveococcosis, permits to obtain good immediate results in highly specialized centres. Today radical operative intervention continues to be the only one method of treatment in the patients, which may guarantee satisfactory late follow-up results.

Objective. To estimate immediate results of surgical treatment of peripheral cholangiocarcinoma in elderly and senile patients. Materials and methods. In 2004-2018 yrs period in the Department of Transplantation and Surgery of the Liver of the Shalimov National Institute of Surgery and Transplantology 84 patients, suffering peripheral cholangiocarcinoma, were radically operated: 31 (36.9%) patients older than 60 yrs (the main Group), and 53 (63.1%) patients, younger than 60 yrs (control Group). Results. Postoperative clinically significant (IIIa-IV degree in accordance to classification of Clavien-Dindo) complications during 90-days of postoperative period were noted in 29.1% patients of the main Group and in 32.1% patients of a control Group (p=0.262), postoperative hepatic insufficiency, in accordance to The International Study Group of Liver Surgery criteria, - in 16.1 and 22.6% accordingly (p=0.473); reoperation was performed in 9.6 and 9.4% patients, accordingly (p=0.973). The causes of postoperative lethality in 2 patients of the main Group were an acute myocardial infarction (1) and an acute pulmonary thromboembolism (1). Conclusion. Hepatic resection is characterized by satisfactory immediate results of treatment of peripheral cholangiocarcinoma in elderly and senile patients, if performed in highly-specialized multidisciplinary centre and thorough selection of patients.

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Purpose of the study. The purpose of the study is to improve the results of surgical treatment of patients with purulent-septic lesion of the liver substantiating the indication for resection method use. Material and methods. The work is based on a comparative analysis of the results of examination and treatment of 64 patients aged 10 to 81 years old, with chronic liver abscesses in the department of surgery and liver transplantation during the 1995–2016 periods. According to the tasks of the study patients are divided into two groups. In 30 (46,8%) patients (the study group), various types of anatomical resection of the liver with a purulent lesion were performed without its dissection during the operation; in 34 (53,2%) patients (group of comparison) they performed the disclosure, sanation, drainage of purulent cavity. The majority of patients with chronic liver abscesses treated the abscess with a puncture or drainage method under the control of ultrasound in other medical institutions of Ukraine. Results. The results of diagnosis and treatment of 64 patients for chronic liver abscesses from 1995 to 2016 are analyzed. In the study group, the patients performed anatomical resection of the liver, in the comparison group – standard surgical interventions – the disclosure and drainage of the abscess of the liver. The duration of antibiotic therapy after surgery in the comparison group is significantly higher than in the study group, respectively, 22 ± 3,4 and 5,75 ± 1,6 days; p < 0,001. Second-line antibacterial drugs after draining operations were used more often (p < 0,001) than after resection interventions, respectively, in 94,1 and 6,6% of cases. The duration of treatment of patients in the hospital after surgery in the study group was less than in the comparison group, according to 15,1 ± 0,7 and 27,3 ± 3,05 days; total 25,9 ± 1,4 and 45,7 ± 3,45 days (p < 0,001). After drainage operations, drainages from the abdominal cavity were removed later than after resection interventions, respectively, 17,1 ± 2,8 and 6,35 ± 1,1 days (p < 0,001), through. Conclusion. Resection for chronic purulentseptic lesions of the liver is the priority methods of surgical treatment. The analysis of the obtained results allows us to conclude that resection technologies contribute to the rapid normalization of physical and social rehabilitation of patients with septic liver damage. Keywords: liver abscess, liver resection, chronic, purulent-septic.