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.

Мета. Порівняння функціональної активності печінки після трансплантації правої частки від живого родинного донора з серединною веною та без неї. Матеріали і методи. Проаналізовано результати 75 трансплантацій правої частки печінки від живого родинного донора у двох групах реципієнтів: 1–ша група – реципієнти (37), яким трансплантовано праву частку печінки з серединною веною, 2–га група – реципієнти (38), яким трансплантовано праву частку печінки без серединної вени. Для аналізу використовували дані біохімічних показників крові в обох групах протягом першого тижня та на 10, 14, 21, 30–ту добу після трансплантації. Результати. Встановлено, що пікові рівні аланінамінотрансферази (АЛТ), аспартатамінотранферази (АСТ) і загального білірубіну були вищими у 2–й групі (відповідно 384,43; 399,77 і 206,70), ніж у 1–й групі (відповідно 212,64; 285,57; 203,18). Суттєвої різниці між рівнями гамаглутамілтранспептидази (ГГТП), лужної фосфотази (ЛФ), показниками протромбінового часу (ПЧ) і міжнародного нормалізованого співвідношення (МНС) не було. Висновки. Формування адекватного венозного відтоку від п’ятого та восьмого сегментів трансплантата правої частки печінки забезпечує ефективність його функціонування. Функція трансплантата правої частки печінки з серединною веною відновлюється більш повноцінно порівняно з трансплантатом без серединної вени за рахунок відсутності венозного застою в правій частці печінки.

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Objective. To estimate the immediate and late results in recipients while transplantation of the hepatic right part with median hepatic vein and without her. Маterials and methods. Postoperative data about 86 patients, to whom the hepatic right half was transplanted in 2003 - 2018 yrs., with the objective to estimate the impact of presence of median hepatic vein in the transplant on the morbidity rate development, were analyzed. The patients were divided into two groups: Group I - the patients, to whom the hepatic right half was transplanted without median hepatic vein, while Group II - the patients, to whom the hepatic right half was transplanted with median hepatic vein. Results. The investigation have revealed a higher rate of vascular complications in patients, to whom the hepatic right half was transplanted without median hepatic vein, comparing with the patients, to whom the hepatic right half was transplanted with median hepatic vein. The infection-septic complications have developed more frequently in patients, to whom the hepatic right part was transplanted without median hepatic vein. Nonspecific surgical morbidity developed in 10 (23.3%) patients of the Group I and in 8 (18.6%) patients of the Group II. The rate of development of the small hepatic transplant syndrome was higher in the Group I. Оne-year, two-year and five-year survival in the Group I have constituted 79, 72 and 69% accordingly, in the Group II - 83, 74 and 70% accordingly. Conclusion. Our experience of performance of the hepatic right half transplantation witnesses, that presence of median hepatic vein in the transplant correlates with lowering of the postoperative morbidity rate, as well as with frequency of development the small hepatic transplant syndrome, postoperative mortality and the stationary stay duration.