Combined surgical procedures in liver and biliary tract diseases

: The indications and contraindications for simultaneous surgical correction of the diseases of hepato-biliary system remain unclear and debatable. 308 patients at the age of 20-78 years have been operated on liver, biliary tract in combination with surgery on other organs. More than 600 operations have been performed. The rate of morbidity was 1.6% lethality-2.3% (7 patients). The risk of death was increased for patients over 60 years of age, who had urgent combined operations. The optimal operative access and drainage were of a special importance. Intramuscular Heparin injections in the dose of 5000 units 4 times a day were used in patients over 60 years of age and in case of 3d or 4th degree of obesity. Liver and biliary tract surgery was combined with resection of the stomach, hernioplasty, appendectomy, echinococcectomy, hemicolectomy, nephrectomy, thyroid gland's resection, amputation of the uterus, sectoral resection of the buast and others. Endotracheal anesthesia was used in all the cases.