Ж.Р. Оспан

https://orcid.org/0000-0001-6803-5806

Найдено статей: 3

  • Acute Liver Failure On The Background Of Chronic Liver Disease Due To Hepatitis Virus Reactivation (Выпуск № 3, 2025)

    Bolatbek Baimakhanov, Shokan Kaniyev, Maxat Doskhanov, Almagul Jumabaeva, Zhambyl Ospan, Milliyenium Maulen, Ainur Aftandilkyzy, Magzhan Tursynbay
    2025-09-30
    4–9
    Аннотация

    Today, hepatitis B virus-associated acute liver failure remains the leading cause of liver failure (44% mortality in Asia and 41% in the United States). Studies show that among patients with hepatitis B-associated cirrhosis, acute liver failure develops in 10-20% of cases. Acute liver failure on chronic liver disease is a potentially reversible syndrome that occurs in patients with cirrhosis or chronic liver disease and is characterized by acute decompensation, organ failure, and high short-term mortality. Chronic hepatitis B virus infection is a leading cause of liver morbidity and mortality worldwide. When we talk about hepatitis B, there is a high risk of developing super infection hepatitis D, since hepatitis D remains infectious and can reactivate at very low titers that are not detected using modern analysis methods if HBsAg remains in the blood serum. The interaction of these viruses leads to accelerated progression of fibrosis and cirrhosis of the liver, which significantly increases the risk of developing acute liver failure against the background of chronic.

    In our case, a patient diagnosed with liver cirrhosis as a result of viral hepatitis B with delta agent, class C according to Child–Pugh–Turcotte, MELD-36 points, the patient developed a severe form of acute renal failure, which required emergency intervention, so he was not included in the waiting list for a transplant from a cadaveric donor. His wife became the donor, which is an example of living donation, which provides higher chances of successful recovery due to a shorter waiting time and a lower risk of graft rejection. Timely examination of the donor and recipient, as well as prompt liver transplantation, contributed to a favorable outcome of the disease.

    Ключевые слова

    acute-on-chronic liver failure, liver transplantation, viralre activation, decompensated cirrhosis

  • Fatty liver disease after pancreatoduodenectomy and total pancreatectomy (Выпуск № 1, 2025)

    S. Tileuov, A. Dzhumabekov, B. Baimakhanov, M. Doskhanov, S. Kaniyev, J. Ospan, Y. Yenin, M. Tursynbai
    2025-03-31
    20–28
    Аннотация

    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.

    Ключевые слова

    pancreatoduodenectomy, fatty liver disease, pancreatic cancer, liver failure, exocrine pancreatic insufficiency

  • Первый опыт лапароскопического гепатикоеюностомоза при стриктурах желчных протоков (Выпуск № 2, 2024)

    М.О. Досханов, А.А. Хаджиева, Б.Б.. Баймаханов, Ш.А. Каниев, М.А. Сейсембаев, Ж.Р. Оспан, Ш.М. Теипов
    2024-06-28
    50–60
    Аннотация

    Фон. Повреждение желчных протоков - потенциально опасное для жизни состояние, характеризующееся высокой заболеваемостью и смертностью, которое происходит вследствие ошибочной манипуляции во время хирургического вмешательства, такого как неправильная идентификация протоков, неправильное клипирование или термическое воздействие. Целью исследования является изучение эффективности применения лапароскопического гепатикоеюноанастомоза у пациентов с постхолецистэктомическими повреждениями желчных протоков и сравнить его с традиционной открытой техникой. Материал и методы. Проведен ретроспективный анализ результатов лапароскопического и открытого гепатикоеюноанастомоза у пациентов с повреждениями желчных протоков за 2017 - 2023 гг.

    Результаты. Лапароскопически оперировано 28 пациентов, открытым способом – 57 пациентов. Отмечены статистически значимые различия в наличии наружного желчного свища, размерах диаметра анастомоза, в длительности операции, послеоперационных осложнений, послеоперационного периода. Отсутствовали значимые различия в частоте интраоперационных осложнений.

    Заключение. Лапароскопический подход при лечении стриктур желчных протоков по классификации Страсберга Е1 - Е2 безопасен и эффективен.

    Ключевые слова

    Повреждение желчных протоков, холецистэктомия, лапароскопическая гепатикоеюностомия, гепатикоеюноанастомоз