RESULTS AND COMPLICATIONS OF COMPLEX TREATMENT OF PATIENTS WITH LIVER CYRRHOSIS COMPLICATED BY BLEEDING WITH THE USE OF MINIMALLY INVASIVE TECHNOLOGIES

From 2010 to 2015, under our supervision there were 360 patients with liver cyrrhosis. After stopping the bleeding and stabilizing the patient’s condition in 72 cases to prevent recurrent bleeding endovascular embolization splenic artery by our modified method was carried out. In 60 cases, in order to prevent recurrence of bleeding, we carried out laparoscopic operations — coagulation and ligation of the veins and arteries of the short gastric greater curvature of the stomach and also 18 laparoscopic vertical resections of fundus of the stomach. In 84 cases, after the use of conservative therapy to stop bleeding, we managed in 50 (59%) cases. Rebleeding was seen in 34 (41%) cases, mortality was 33 (19%) cases. We applied different methods of local endoscopic hemostasis in 276 cases. We managed effectively stop the bleeding in 224 (81%) cases. Mortality due to inefficiency of local hemostasis was observed in 52 (19%) patients. We had no mortality after performing operations of endovascular embolization. We also had no mortality after laparoscopic devascularization. Analyzing the obtained results we should note that local endoscopic hemostasis can effectively stop the bleeding from the varices of the esophagus and stomach, and endovascular and laparoscopic procedures allow in addition also reduce the accuracy of recurrence of bleeding and mortality in the long term period.