Planning of the Autotransplantation of the Liver to the Patients with Advanced Alveococosis Based on the Multidetector Computed Tomography

Abstract

Aim: to analize computed tomography data while planning autotransplantation of the liver for advanced alveococcosis.Materials and Methods.A retrospective analysis of the results of multidetector computed tomography of the abdomen and retroperitoneal space of 7 patients with advanced liver alveococcosis was made in order to plan autotransplantation. Besides a description of the location and size of parasitic lesion for each patient relationship with main vessels was evaluated - the inferior vena cava, hepatic and portal veins, hepatic arteries, and the presence of extrahepatic component. The vessel assessed as involved in the pathological process not only in case of clear invasion, but also with abutment because of infiltrative growth of alveococcus. The accuracy of the method was estimated by comparison with the intraoperative data.Results.The data of computed tomography while the planning of liver autotransplantation coincided with the intraoperative data in all examined patients. The main criteria indicating the need for this type of surgical intervention was the involvement of the retrohepatic part of the inferior vena cava to the caval gates inclusive and/or hepatic veins. With extrahepatic spread of parasitic masses it is possible to affect not only the surrounding organs, but also the main vessels, for example, with growth in the hepatic-duodenal ligament. Thus, in one patient during the operation, the occlusion of artery hepatica propria was confirmed. In two cases of recurrence of the parasitic process after rightsided hemihepatectomy, the almost identical pattern of involvement of the liver resection surface, inferior cava and portal veins, diaphragm, adrenal gland in combination with a extent adhesive process in the right subdiaphragmal space.Conclusions.CT scan data allowed to correctly plan the volume of operative intervention – autotransplantation of the liver – in all the examined patients. It is of interest to evaluate the accuracy of the method on a larger group of patients.