Ш.А. Каниев

https://orcid.org/0000-0002-1288-0987

Найдено статей: 8

  • 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

  • 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 (Выпуск № 3, 2024)

    Z.R. Ospan, M.О. Doskhanov, B.B. Baimakhanov, S.A. Kaniyev, M.S. Nagasbekov, S.T. Tileuov, M.U. Suierkulov
    2024-09-30
    38–45
    Аннотация

    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.

    Ключевые слова

    Living donor liver transplantation, Hepatic vein, Vascular graft, Venous reconstruction models

  • CT and MRI referral practices under mandatory social health insurance (Выпуск № 4, 2024)

    D. Baiguissova, A. Sadykova, M.A. Baimuratova, A.R. Ryskulova, Ye. Kalshabay, A.N. Mukhamejanova, G. Battalova, A. Kabidenov, S.A.² Kaniev
    2024-12-31
    57–65
    Аннотация

    Background. Modern imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), are vital for diagnosing and monitoring diseases. Despite their value, challenges include high costs, radiation risks, and limited accessibility. Effective use requires collaboration between general practitioners (GPs) and radiologists. Misguided referrals burden healthcare systems, while underuse delays diagnoses. Objective. This study assesses GPs’ awareness of CT/MRI indications, examines challenges in referrals under the mandatory social health insurance framework, and analyzes radiologists’ views on unjustified referrals.

    Methods. Two surveys were conducted: one among 108 radiologists in Almaty and Astana and another among 163 GPs in Almaty and the Almaty region. Questionnaires included closed and open-ended questions, and responses were analyzed to identify barriers and optimize diagnostic processes.

    Results. Among radiologists, 56.5% reported more than five unjustified referrals per month, with CT being the most overused modality (80.6%). Reasons included GPs’ lack of knowledge about indications (66.7%) and patient pressure (67.6%). GPs cited limited mandatory social health insurance framework quotas (29.3%) and long waiting times (19.9%) as significant barriers. Both groups emphasized the need for clear clinical guidelines, enhanced education, and better interprofessional communication.

    Conclusion: Systemic improvements in radiology services are necessary. Key recommendations include developing national clinical guidelines, educating GPs on CT/ MRI indications, and streamlining administrative processes. These measures will reduce unjustified imaging, improve resource use, and enhance patient care.

    Ключевые слова

    radiology, CT, MRI, general practitioners, mandatory social health insurance

  • Combined surgery of lung echinococcosis (Выпуск № 4, 2024)

    B.K. Shirtayev, S.A. Kaniyev, G.N. Ismailova, N.Zh. Yerimova, D.R. Kurbanov, M.G. Aitzhanov, N.N. Rakhman
    2024-12-31
    25–33
    Аннотация

    Background. Pulmonary cystic echinococosis, a parasitic disease, is a health care problem in developing countries. In this study, we evaluated outcomes of patients with pulmonary hydatid disease who were treated in our department.Study was performed to compare results of surgical treatment and complications of patients with unilateral or bilateral thoracic and combined pulmonary cystic echinococosis.

    Methods. This cross-sectional analysis of a prospective study was conducted in the Department of Thoracic and Pediatric Surgery, Scientific Center of Surgery, Almaty, Kazakhstan among 598 patients with pulmonary cystic echinococosis, who had surgical treatment with various surgical methods, depending on the prevalence of echinococcosis, as follows: right lung in 357 (59.5%) patients, left lung in 243 (40.5%) patients, bilateral in 95 (15.8%) patients, and complicated echinococcosis in 317 (52.8%) patients. Length of stay per hospital stay has been decreased (p 0.0001) by video-thoracoscopicechinococcectomy with the high-energy laser treatment of cyst, than after echinococcectomy by cyst treatment with povidone-iodine. Treatment with formalin presented the longest hospital stay (p 0.0001).

    Results. Comparative analysis of patients with uncomplicated and complicated pulmonary cystic echinococosis showed a high frequency of postoperative complications associated with complicated echinococcosis (OR = 2.2, p 0.0001).

    Conclusion. Despite the success of surgical treatment of pulmonary cystic echinococosis, issues of intraoperative dissemination and safety remain, and treatment success rates can be improved. These factors require further prospective multicenter studies.

    Ключевые слова

    pulmonary cystic echinococosis, video- assisted thorascopicechinococcectomy, bilateral echinococcosis, transmedistinal access, combined echinococcosis

  • Thrombosis of mechanical valve prosthesis: a case report (Выпуск № 4, 2024)

    B.A. Rakishev, A.B. Kudaibergen, U.E. Imammyrzayev, R.S. Taimanova, A.D. Temirkhanov, S.A. Kaniyev
    2024-12-31
    19–24
    Аннотация

    Mitral valve prosthesis thrombosis is a rare but life-threatening complication associated with mechanical heart valves. It requires timely diagnosis and prompt intervention to prevent severe morbidity and mortality. We report the case with hemoptysis, severe dyspnea, and fever, two years after mechanical mitral valve replacement with a St. Jude Medical prosthesis. Despite consistent anticoagulation therapy, recent transition from warfarin to low-molecular-weight heparin during hospitalization for pneumonia may have contributed to prosthetic thrombosis. Echocardiography revealed significant mitral valve dysfunction with a mean pressure gradient of 45 mmHg and evidence of thrombus formation. Emergency surgery confirmed total prosthetic valve thrombosis and necessitated thrombectomy and replacement with a new mechanical valve. Postoperative recovery was uneventful, with improved hemodynamics and resolution of pulmonary edema. This case highlights the complexities of managing mechanical valve thrombosis in patients with multiple risk factors, including anticoagulation changes, atrial fibrillation, and recurrent pulmonary infections. The surgical approach remains the gold standard for treatment, though emerging evidence supports the potential role of thrombolysis in select cases. In conclusion, mitral valve prosthesis thrombosis represents a significant challenge requiring multidisciplinary management and strict anticoagulation monitoring, and the importance of developing standardized protocols for early diagnosis, anticoagulation management, and surgical intervention.

    Ключевые слова

    Dysfunction of a mechanical prosthesis, prosthetic thrombosis, pulmonary edema, anticoagulant therapy

  • Какие шкалы должен использовать кардиолог у пациентов с фибрилляцией предсердий? Что нового? (Выпуск № 2, 2024)

    К.А. Бижанов, А.К. Баимбетов, Б.Б. Баймаханов, Ш.А. Каниев, О.Т. Ибекенов, А.Б. Сарсенбаева, Г.Н. Исмаилова
    2024-06-28
    61–77
    Аннотация

    Современный алгоритм лечения больных с неклапанной фибрилляцией предсердий (ФП) предполагает антикоагуляцию с целью профилактики инсульта и системных эмболий, улучшение контроля симптомов ФП путем урежения частоты сердечных сокращений или восстановления и удержания синусового ритма и лечение сердечно-сосудистых и других сопутствующих заболеваний. Обследование пациентов с ФП должно быть структурированным и включать в себя оценку риска инсульта, выраженности симптомов, тяжести нагрузки ФП (тип аритмии, число и длительность эпизодов и т.п.) и предрасполагающего состояния. Важное значение имеет использование шкал CHA2DS2-VASc (риск инсульта), HAS-BLED (риск кровотечения), шкалы EHRA (выраженность симптомов ФП) и 2MACE (риск сердечно-сосудистых исходов), которые помогают оценить вероятность неблагоприятных исходов и выбрать оптимальное лечение, обеспечивающее защиту не только от инсульта, но и от сердечно-сосудистых событий. Следует отметить, что шкала HAS-BLED в первую очередь необходима для идентификации факторов риска кровотечений, модификация которых позволяет повысить безопасность антикоагулянтной терапии, а высокое значение индекса по этой шкале не может служить основанием для отказа от антикоагуляции у пациента с ФП. Предложены новые шкалы оценки риска инсульта и геморрагических осложнений у больных с ФП на основе клинических показателей и лабораторных биомаркеров, однако их возможные преимущества перед существующими индексами нуждаются в подтверждении в специальных исследованиях.

    Ключевые слова

    Фибрилляция предсердий, инсульт, кровотечение, шкалы, прямые пероральные антикоагулянты, инфаркт миокарда, интервенционная аритмология, кардиология

  • 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