Kursk oncosurgeons have grown a patient liver in 10 days and saved his life

The malignant tumor has already metastasized to the liver, affecting the right lobe and part of the left. Of the eight segments of the organ, only three were preserved, and the volume of the remaining part of the liver after removal should be at least 35-40%. In the patient, this figure was critically low - less than 28%.

First, experts tried to grow the hepatic residue using a minimally invasive procedure - embolization of the right portal vein. However, due to pronounced fibrous changes, there was no significant increase in volume. Then a team of surgeons consisting of the deputy chief physician for the medical unit Egor Grebenkin, head of the department Maxim Polyansky and oncologist Vladimir Shcherbakov decided to perform an ALPPS operation. This is a two-step technique that allows you to radically remove large volumes of the liver with an initially insufficient size of the remaining parenchyma.

In the first stage, surgeons bandaged the right branch of the portal vein and completely divided the parenchyma between the affected and healthy lobes, leaving them physically isolated but connected by vessels and bile ducts. Then came the waiting period for the growth of the remainder. On the 7th day, the volume of the liver increased to 34%, and on the 10th - to the necessary 38%, which allowed to successfully conduct the second stage and remove the part of the organ affected by the tumor.

As noted by Egor Grebenkin, the patient’s situation was stalemate: chemotherapy did not give the desired effect, and the only chance was surgery. The man refused to go to Moscow and insisted on treatment in Kursk. Grebenkin stressed that such operations are very high mortality, but weighing all the risks together with colleagues and the patient, the doctors decided to operate. According to him, the risk was justified, and he thanked colleagues for excellent work, and the patient for a strong will to live.

It is noted that operations of the ALPPS type are usually the prerogative of the largest federal clinics and were not previously performed in regional oncological institutions of the Central Federal District. Thanks to the equipment and qualification of employees of the Kursk Cancer Center, all patients in the region and neighboring regions can be successfully operated on the spot, without being referred to federal clinics.