B. Baimakhanov
https://orcid.org/0000-0002-9839-6853
Articles found: 3
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Fatty liver disease after pancreatoduodenectomy and total pancreatectomy (Issue № 1, 2025)
S. Tileuov, A. Dzhumabekov, B. Baimakhanov, M. Doskhanov, S. Kaniyev, J. Ospan, Y. Yenin, M. Tursynbai2025-03-3120–28Abstract
Pancreatoduodenectomy is the only treatment method for patients with pancreatic head and periampullary region tumors. It is known that some long-lived patients develop exocrine pancreatic insufficiency after surgery. One of the consequences of exocrine pancreatic insufficiency is fatty liver disease, which has been reported to occur in 7.8% to 40.0% of patients after pancreatoduodenectomy. We reported two clinical cases of patients who underwent pancreatoduodenectomy and total pancreatectomy for pancreatic head cancer and intraductal papillary mucinous neoplasm of the main pancreatic duct. After surgery, they developed rapidly progressive fatty liver disease with no history of liver disease, leading to death from liver failure 20 days and 3 months after surgery. Severe malnutrition caused by exocrine pancreatic insufficiency, postoperative eating disorders, and exacerbation of diabetes mellitus were the main factors contributing to the rapid deterioration of the condition. This clinical case highlights the possibility of developing life-threatening fatty liver disease with severe fibrosis after pancreatoduodenectomy and total pancreatectomy. Careful monitoring of liver status, regular nutritional assessment of patients, prophylactic replacement of pancreatic enzymes, and ensuring adequate nutrition are important.
Keywords
pancreatoduodenectomy, fatty liver disease, pancreatic cancer, liver failure, exocrine pancreatic insufficiency
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The effectiveness of the functioning of reconstructed hepatic veins using various types of materials in transplantation of the right lobe of the liver from a living donor (Issue № 3, 2024)
Z.R. Ospan, M.О. Doskhanov, B.B. Baimakhanov, S.A. Kaniyev, M.S. Nagasbekov, S.T. Tileuov, M.U. Suierkulov2024-09-3038–45Abstract
Background. In adult living donor liver transplantation with the right lobe, the venous outflow of the anterior sector is typically restored during the procedure to form a neo-middle hepatic vein. Restoring the middle hepatic vein for the drainage of the anterior sector is critically important for achieving optimal graft function. Various conduits are used for this reconstruction, such as synthetic and biological grafts (e.g., the recipient's portal vein, vessels from a deceased donor, and modified great saphenous vein). However, the selection of the best option remains a topic of discussion. This study evaluates the effectiveness of using biological and synthetic grafts for MHV reconstruction.
Materials and methods. A retrospective analysis of outcomes was conducted in patients who underwent transplantation of a modified right liver lobe due to end-stage liver disease from 2011 to 2024.
Results. A transplantation of modified right liver lobes was performed on 80 patients. In 69 cases, the reconstruction of the hepatic veins was carried out using a biological graft, while in 11 cases, a synthetic graft was used. Statistically significant differences were noted in mortality and the postoperative period. No significant differences were found in the frequency of intraoperative complications.
Conclusion. Our study demonstrates that the use of a biological graft for the reconstruction of the hepatic veins of segments 5 and 8 is more effective than the application of a vascular prosthesis.
Keywords
Living donor liver transplantation, Hepatic vein, Vascular graft, Venous reconstruction models
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FIRST EXPERIENCE OF LAPAROSCOPIC HEPATICOJEJUNOSTOMY FOR BILE DUCT STRICTURES (Issue № 2, 2024)
M. Doskhanov, A. Khajiyeva, B. Baimakhanov, S. Kaniyev, M. Seisembaev, Z. Ospan, S. Teipov2024-06-2850–60Abstract
Background. Bile duct injury is a potentially life-threatening condition characterized by high morbidity and mortality, which occurs as a result of erroneous manipulation during surgical intervention, such as incorrect identification of the ducts, improper clipping, or thermal injury. The aim of the study is to investigate the effectiveness of laparoscopic hepaticojejunostomy in patients with post-cholecystectomy bile duct injuries and compare it with traditional open techniques. Materials and
Methods. A retrospective analysis of the results of laparoscopic and open hepaticojejunostomy in patients with bile duct injuries from 2017 to 2023 was conducted.
Results. Laparoscopic surgery was performed on 28 patients, while open surgery was performed on 57 patients. Statistically significant differences were noted in the presence of external biliary fistula, diameter of the anastomosis, duration of the operation, postoperative complications, and postoperative period. There were no significant differences in the frequency of intraoperative complications.
Conclusion. The laparoscopic approach in treating bile duct strictures classified as Strasberg E1 - E2 is safe and effective.
Keywords
Bile duct injury, cholecystectomy, laparoscopic hepaticoejunostomy, hepaticoejunoanastomosis