Хирургическая тактика при травматических повреждениях печени с позиций современных технологий (клинико-экспериментальное исследование)

The article presents the results of clinical and experimental research of abdominal ischemic syndrome. An experimental study has been performed on 20 pigs by creating extended pneumoperitoneum under endotracheal anesthesia during 6 hours: I group included 6 animals with intra-abdominal pressure at 16-20 mm Hg, II group (6 pigs) – 21 -25 mm Hg, III group (8 piglets) – more than 26 mm Hg. Then the evaluation of biochemical parameters of blood, urine, lymph, with chemiluminescence of biological fluids and with the study of metrological parameters of serous membranes and peritoneum using LACK-02 unit has been made. After pneumoperitoneum had been eliminated the tissues of the liver and other organs were extracted for histological examination. The clinical material included 137 patients with various degrees of liver traumatic injuries. The results of clinical and experimental studies show that during postoperative period in 77,4% of cases the liver injury is complicated by intra-abdominal hypertension, in 4,4% by compartment syndrome. If not prevented intra-abdominal hypertension may lead to ischemic and reperfusion injury of the liver. The developed algorithm of treatment patients with liver injury has reduced the rates of postoperative complications from 19,7% to12,4%, mortality from 11,2% to 5,8%.