Ischemia/reperfusion injury and its prevention in liver surgery (literature review)
Summary. The Pringle maneuver is traditionally used during hepatectomy to reduce blood loss, but the effect on the metabolic function of hepatocytes is potentially harmful. It is invariably complicated by ischemia/reperfusion (I/R) injury, which can reduce the capacity of the liver remnant to maintain adequate postoperative function and cases acute liver failure. The aim of this review was to examine world experience about use of hepatoprotective methods aiming at attenuating I/R injury. Actual topics of hepatobiliary surgery are study the protective mechanisms of various hepatoprotective methods such as ischemic preconditioning, ischemic postconditioning and pharmacological postconditioning. Programs of ischemic warning are recommended to perform at major resection of the liver to prevent ischemic-reperfusion injury of the liver and reduce the risk of occurrence in the postoperative period the acute liver failure. The use of transplant technology in oncosurgery will expand the indications for a radical treatment of patients with tumor lesion of the liver.
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