| 摘要 |
FIELD: medicine. ^ SUBSTANCE: method involves performing radial hepatotomy - 14 with access to source of bleeding in liver parenchema - 1 without liver resection after section by sharp method (scalpel) of liver capsula from wound - 2 towards liver gate - 9 taking into account segmented structure of liver. After that, liver parenchema is bluntly separated from liver edge towards wound - 2 and liver gate - 9 parallel to large tubular structures (blood vessels - 3, bile ducts - 4), with presence in wound - 2 of large unaffected tubular structures the latter are not crossed and ligated. With inefficiency of haemostasis electrocoagulation is used, Tachocomb plate or sewing - 10 parts of liver parenchema - 1. Then visual revision of wound canal - 2 is carried out, with further detection of source of bleeding or bilorrhea or both, after which final surgical haemostasis is performed by means of suturing - 11 of wounds of large arteries, veins - 3 or by means of ligating - 15 affected subsegmental blood vessels - 3, subsegmental bile ducts - 4, after which suturing of liver wound is performed. ^ EFFECT: increased reliability of operation in case of deep liver injuries. ^ 12 dwg, 2 ex |
