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The main aim of the present study was to determine the clinical significance of the DNA methyltransferase 3B (DNMT3B) gene -579 GT polymorphism in colorectal cancer (CRC) patients.A total of 140 patients with CRC and 164 healthy individuals were included in the study. According to the manufacturer's instructions, DNA was isolated from blood, and genotypes were determined on agarose gel by the PCR-RFLP method. Genotype confirmation was performed using Sanger sequencing in randomly selected samples.When comparing the case and control groups, heterozygous GT (OR=0.53; 95% CI=0.32-0.88), under the dominant model (OR=0.53; 95% CI=0.33-0.87), and the mutant T allele (OR=0.71; 95% CI=0.51-0.98) were statistically associated with a reduced risk of CRC. However, when the age, pathological tumor grade and stage, smoking habit, and alcohol consumption were compared, no significant relationship was determined (P0.05). Furthermore, among males, heterozygous GT was associated with a reduced risk of CRC (OR=0.40; 95% CI=0.19-0.84).Our study highlighted that the -579 GT polymorphism of the DNMT3B gene plays a protective role against CRC development.

Modern concepts of hepatic insufficiency, their advantages and faults: views of a general surgeon and transplantologist

Background Early prediction of liver dysfunction after liver resection remains a challenge. We hypothesized that extracellular histone concentrations are a promising new biomarker for the detection of liver injury after donor hepatectomy. Methods This prospective study considered 93 living donors who underwent hepatectomy. Blood samples of donors were collected on postoperative day 1, and histone levels in the plasma samples of the patients were measured with total histone H3 sandwich ELISA kits. Among 86 right lobe donors, 23 (26.7%) were deemed to have a delayed liver function recovery according to the International Study Group of Liver Surgery's definition of posthepatectomy liver failure, whereas 63 (73.3%) were considered to have an adequate liver function recovery. Results The area under the receiver operating characteristic (ROC) curve for circulating histones in predicting persistent liver dysfunction was 0.618 ± 0.06 (95% confidence interval [CI], 0.501-0.735; P = .091). The cutoff point value obtained from the analysis of ROC curves was 0.895, with a sensitivity of 95.7% and a specificity of 32.9%, respectively, for examining a delayed liver function recovery (P = .015). The Fisher analysis significantly verified these results empirical influence function % 7.90 (95% CI, 3.91-11.90; P = .006). The univariate analysis determined that postoperative histones were identified as an independent risk factor of delayed liver function recovery (odds ratio, 10.8; 95% CI, 1.4-84.9; P = .024). Conclusions The circulating histone negatively correlates with liver dysfunctions after donor hepatectomy and had the best value in predicting liver dysfunction within 24 hours after liver resection.

lt;bgt;Introduction:lt;/bgt; Adenomatous polyps are pivotal to the development of colorectal cancer. The risk of colorectal carcinogenesis can be reduced through polypectomy and close surveillance of the disease. Early-stage polyps can be detected and removed endoscopically, therefore, reducing the incidence of carcinoma. The identification of CSC in colon polyps allows for assessment of their potential malignancy. Therefore, it is very relevant to study the prognostic significance of the prevalence of stem cells in colorectal polyps in early detection and prevention of cancer.lt;/brgt;lt;/brgt;lt;bgt; Method:lt;/bgt; Previously pathologically evaluated adenomatous tumors (60M, 40F) at Azerbaijan Medical University were reevaluated in Meram Medical Faculty Pathology Department. Hematoxylin-Eosin-stained slides were examined and cases with and without dysplasia were determined. New sections were taken from paraffin blocs. Prominin-1 staining was performed immunohistochemically on these sections. Stained slides were examined by an image analysis system. Prominin-1-positive cells were automatically counted with the same image analysis system. The cases that developed malignancy after polypectomy were determined. The relationship between CD133 expression of dysplasia and malignancy was statistically analyzed.lt;/brgt;lt;/brgt;lt;bgt; Results:lt;/bgt; Statistically significant prominin-1 expression was detected in cases with dysplasia and malignancy.lt;/brgt;lt;/brgt;lt;bgt; Conclusion:lt;/bgt; The investigation of prominin-1 expression in colorectal polyps may be important to determine malignancy development.

Background/aim This study represents the first report that evaluates the experience gathered from diagnosis, surgical treatment and outcome of insulinoma patients from Azerbaijan. Materials and methods We retrospectively review of insulinoma patients for a 10-year period. Collected data included patient demographics, laboratory and imaging tests, detailed surgical reports, histopathological examination of resected specimens, and clinical follow-up. Results Twenty-one insulinoma patients were identified. Male patients comprised 52.4%; mean age was 44 years. Mean time to diagnosis was 14 months; 61% patients had ≥3 medical referrals due to hypoglycemia-related symptoms. Diagnosis sensitivity of CT, MRI and US was 85%, 80%, and 55%, respectively. The mean glucose, insulin, C-peptide levels were 35.7 ± 9.5 mg/dL, 33.5 ± 21.9 μU/mL, and 3.74 ± 1.88 ng/mL, respectively. Pancreatic head and tail were the most frequent tumor locations; mean tumor size was 1.5 ± 0.7 cm. No statistical association was found between the tumor size and preoperative glucose, C-peptide and insulin levels. Distal pancreatectomy and enucleation were the most common surgical procedures. Local tumor recurrence rate was 14%. There was no mortality. Conclusions To prevent delayed diagnoses, physicians should be familiar with the typical symptoms of these rare tumors.

Background and objective: The chosen study mainly investigates the importance of immunohistochemical expression of Ki-67 in Colorectal polyps which are considered intraepithelial neoplasms and can be found in diverse dimensions from small polyps to large ones. During the examination process, dysplasia was observed in all polyps examined in the Ki-67 proliferation index. The study will clarify also their relationship to the size, dysplasia, and location of the polyps. Malignancy of the polyps with high and low dysplasia is far more expected. The idea of the development of colorectal cancer from previously existing adenomas has been widely spread based on epidemiological, clinical, postmortem and molecular biological studies. The significance of cell proliferation in the change of adenomatous polyps into colorectal cancer is incontestable, which is considered an axiom. The Ki-67 protein is another immunohistochemical marker applied for the identification of proliferative cells. So that there is a significant relationship between the type of adenoma and the Ki-67 expression, and three of the polyps in the Ki-67 expression were considered dysplasia. Methods: Between the period of 2011 and 2016, 100 patients, (out of 40 were women and 60 of them were men) with endoscopic polypectomy were retrospectively analyzed at the Endoscopy Department of the Central Customs Hospital. Immuno-histochemically Ki-67 expressive polyps were performed in eight patients involved in the study group. The Ki-67 response was conducted via the monoclonal reflection bodies. (Leica Bond-Maxautomated immune strainer apparatus) The percentage of positively charged cells was recorded as Ki-67 labeling index (Ki-67-LI) and each painted nuclear was considered positive. Results: The retrospective study included 100 paraffin blocks of polypectomized specimens. According to the histological examination of Hematoxylin and Eosin stained (H&E) preparations, there were 45 tubes, 23 tubulovillous, 16 inflammatory, 13 hyperplastic, 2 serrated and one polyp in the villous form were detected. The mid-aged patients were 56.78 ± 1.64. Most of the patients around 38 patients in this study constituted 50 to 69 age groups and five patients were included between 40 to 49 age groups. The gender distribution of the cases was determined in 60 of males, 40 of females. Dysplasia was observed in all polyps examined in Ki-67 proliferation index. There is a significant relationship between the type of adenoma and the Ki-67 expression, and three of the polyps in the Ki-67 expression were considered dysplasia. Conclusions: The study revealed that the Ki-67 immunohistochemical expression is significantly related to the size and the degree of dysplasia in colorectal adenomas, but does not have a significant relationship with the sex, age, and the type colorectal adenomas.

The aim of this study was to evaluate liver resection techniques, increase regeneration and to predict complication after hepatectomies. Results of liver resection in the 165 patients and of the different treatment modalities in the 70 rabbits were analysed. Indication for liver resection was hepatocellulary carcinoma (87), metastasis (27), living-related liver transplantation, hemangioma (17), hydatid cysts (4) and others. Of these 165 patients 59 had concomitant cirrhosis and 54 had chronic hepatitis. A comparative studies of the methods of parenchyma dissection, such as clamp-crashing- CC (in the 45 patients), ultrasonic dissector – CUSA (in the 64 patients) and combined use of the CUSA and argon beam coagulation –CUSA+AC (in the 56 patients) were carried out. Results showed that in patients with associated parenchyma disease the CUSA have no advantage over the CC technique in terms of resection time. CUSA+AC decreased blood loss, operation time, transfusion requirements, portal clamping time and morbidity (from 51,7% to 19,5%) in comparison to the CC and CUSA. So, CUSA+AC seemed to be an effective technique for parenchyma dissection in the both normal and fibrotic livers. Comparative study of the different modalities of the He-Ne laser irradiation (irradiation of the liver, portal blood and intravascular blood) and dalargin in the hepatecomized animals showed that combined use of the intravascular blood laser irradiation and dalargin (BLI+D) increase liver regeneration, decrease hepatocyte injury and restore hepatic function abnormalities. The BLI+D method was used in the 76 hepatectomized patients. Results showed that BLI+D increase regeneration rate, decrease time for restoration of the postresectional functional abnormalities, hepatocyte injury and morbidity from 39,6% to 25,4%. Multivariate analyses showed that four of the 58 studied values have independent prognostic significance only: cirrhosis, preoperative bilirubin, parenchyma resection rate, and intraoperative indocyanin green index (ICG). The ICG test was designed for measurement of functional capacity of the remnant liver before resection. This test showed high sensitivity (91,3%) and specificity (77,8%) rate in the prediction of postoperative complications.

Canlıdan böyrək transplantasiyası ağır dərəcəli xroniki böyrəyin yetməzliyinin ən effektiv müalicəsi kimi qəbul edilmişdir. Mahiyyətcə sağlam donordan böyrəyin birinin xəstəyə köçürülməsiindən ibarət olan bu proses çoxsaylı müayinə və müdaxilələri əhatə edir, yüksək diqqət və professionalism tələb edir. Praktik cəhətdən bu prosesləri 3 hissədə cəmləşdimək olar: canlı donorun müayinəsi və qiymətləndirilməsi, əməliyyat və əməliyyatdan sonrakı müalicə və izləmə. Bu prosesin bütün mərhələlərində ana prinsip donorun həyatına, ömrünə və həyat keyfiyyətinə zərər verməməkdir. Bu kitabda canlı donorların müayinəsi, qiymətləndirilməsi, əməliyyatı və əməliyyatdan sonrakı izlənməsi ilə əlaqədar qaydalardan bəhs edilir.

The monograph is devoted to necrotizing fasciitis, one of the most severe forms of disseminated acute surgical infection, and its special clinical variant - Fournier's gangrene. Epidemiology, etiopathogenesis, clinical presentation, diagnosis and treatment of the disease are described in the book based on modern literary sources and many years of personal experience of the authors. The role of intravascular bacterial invasion (bacteremia) and inflammatory mediators in the pathogenesis of the disease is highlighted in accordance with the evolution of modern sepsis theory. Fournier's gangrene was assessed as a critical situations in surgery, prognostic criteria for the disease and principles of treatment were analyzed. The monograph is intended for family physicians and emergency physicians, surgeons, coloproctologists, urologists, dermatologists and intensivists.

The book is dedicated to the 100th anniversary of the Department of Surgical Diseases of Azerbaijan Medical University. In its century-long history, the department has passed a great and honorable path, starting from ambulatory surgery to laparoscopic-endoscopic and transplantation surgery. He presented information on the stages of the department's development: Faculty of Medicine at Baku State University, the establishment of the Medical Institute (University), the Second World War, the First and Second Karabakh Wars, the division into new departments, the stages of independent Azerbaijan and the establishment of the University's Surgical Clinic. The book contains information about the employees of the department, scientific, practical and educational achievements, dissertations, books, articles, including the materials of the 100th anniversary.

Kitab əməkdar elm xadimi, əməkdar həkim, Tibb elmləri doktoru, Professor Həsən Abbas oğlu Sultanovun əziz xatirəsinə həsr olunmuşdur. Kitab H. A. Sultanovun həyatı və elmi ya¬ra¬dıcılığını, cərrahlıq elminin, klinik cərrahlığın, xüsusi ilə prak¬tik cərrahi koloproktologiyanın inkişafına alimin böyük töh-fələrini özündə əks etdirmişdir. Alim haqqında, onun həkim¬lik fəaliyyəti və elmi tədqiqatlarının nəticələri barədə həm¬kar¬la¬rının, tələbələrinin səmimi fikirləri, təəssüratları və xoş xatirələri geniş işıq¬lan¬mışdır. Tibb tariximizin çanlı və şanlı əfsənələrindən biri haqqında yazılmış bu kitab onun yaddaşlardan heç zaman silinməyəcək xatirəsinə həmkarlarının və tələbələrinin kiçik hədiyyəsidir.

The book contains general rules for the surgical treatment of gunshot wounds of the abdominal cavity in field hospitals. The rules were developed on the basis of the experience of the Karabakh war and information from the literature.

This book provides recommendations for preoperative, intraoperative, and postoperative evaluation and management of living liver donors.

Hepatic steatosis carries a risk of postoperative liver dysfunction in donors and graft nonfunction in recipients. This article discusses the evaluation of fatty infiltration in donor liver parenchyma on multidetector computed tomography.The methods of hepatic fat estimation include measurement of hepatic attenuation in HU and calculation of the liver attenuation index (LAI). Liver attenuation values reflect the degree of steatosis. Average attenuation of liver parenchyma is calculated by placing the circular region of interest of at least 1 cmA total of 52 donors were evaluated as potential recipients (34 men, 18 women; mean age, 33.2 years; range, 23-55 years). In 34 donors liver attenuation index (LAI) values were from 2 HU to 22 HU. An LAI5 HU correctly predicted the absence of significant macrovesicular steatosis. These donors were acceptable for a liver transplant. The LAI values of -10 to 5 HU were suggestive of mild to moderate steatosis (6%-30%); 18 (34.6%) volunteers did not proceed to donation because of negative LAI -5 HU. In 2 cases with LAI of -7 and LAI of -8 liver biopsy was performed, and 30% steatosis was confirmed in the pathohistologic examination. Unacceptable liver biopsy result was considered as contraindication for donation. The LAI values of -10 HU were suggestive of moderate to severe hepatic steatosis of 30% or greater. In these cases liver biopsy is not needed, as such donors are not acceptable for liver transplant.Computed tomography imaging provides a detailed evaluation of fatty infiltration in donor liver parenchyma.

Aim of the study Liver transplantation is widely applied as a standard and effective management of end-stage liver diseases, hepatocellular carcinoma, and acute liver failure. Investigation of morphologic and functional changes in the transplanted graft, gastrointestinal system, and spleen after transplantation is an important ground for assessment of post-transplantation results, early changes related to complications, and evaluation of response to treatment modalities. The aim of this study was to investigate the dynamics of changes in elastography of the liver graft and spleen after living-related liver transplantation. Material and methods The study included 14 cirrhotic patients after living-related liver graft transplantation. Stiffness of the spleen and liver was evaluated before transplantation and at 1, 3, and 6 months after transplantation with a Supersonic Aixplorer Multi Wave device. Each procedure consisted of measuring the density in 10 points (spots) of the organ. The final result was calculated as the mean value of successful measurements (must have been > 60% of all measurements) and expressed in kilopascals. Results The mean value of the liver and spleen stiffness before transplantation was 27 kPa (14–31 kPa) and 51 kPa (38–92 kPa), respectively. The stiffness of the spleen gradually reduced after transplantation to 40.3, 35.4, and 24.1 kPa (P = .001) at 1, 3, and 6 months. The stiffness of the liver graft in patients without complications was stable at 4–5 kPa, whereas the same value in patients with complications was increased (≥ 7.5 kPa). In 5 patients, endoscopic investigation confirmed the significant reduction of varicose veins after surgery. Conclusion Elastography of the liver graft and spleen after liver transplantation can be recommended as a useful-for-patient 1-off method of investigation.

The article proposes the principles for the development of a fuzzy rule-based physician decision support system n to determine the stages of the most common hepatocellular carcinoma (HCC) among malignant tumors of liver. The stages of HCC, i.e., critical situations, are expressed by different combinations of clinical signs of input data and emerging clinical conditions. These combinations shape the multiplicity of possible situations (critical situations) by forming linguistic rules that are in fuzzy relations with one another. The article presents the task of developing a fuzzy rules-based system for HCC staging by classifying the set of possible situations into given classes. In order to solve the problem, fuzzy rules of clinical situations and critical situations deviated from them are developed according to the possible clinical signs of input data. The rules in accordance with the decision-making process are developed in two phases. In the first phase, three input data are developed: nine rules are developed to determine possible clinical conditions based on the number, size, and vascular invasion of tumor. In the second phase, seven rules are developed based on possible combinations of input data on the presence of lymph nodes and metastases in these nine clinical conditions. At this stage, the rules representing the fuzzification of results obtained are also described. The latter provide an interpretation of results and a decision on related stage of HCC. It also proposes a functional scheme of fuzzy rules-based system for HCC staging, and presents the working principle of structural blocks. The fuzzy rule-based system for HCC staging can be used to support physicians to make diagnostic and treatment decisions

Prophylactic interventions for benign diseases of stomach and duodenum remain a controversial issue. Some approaches change with time according to change in knowledge and techniques, others are still relevant. The main focus is on gastric and duodenal diverticula, postoperative delayed gastric emptying, hiatal hernia, gastroesophageal reflux, reflux gastritis, gastroesophageal anastomosis leakage, and gastric volvulus. Brief information on prophylactic gastroenterostomy, gastric partitioning, pyloroplasty, vagotomy, and gastrostomy is given as well.

Weight regain following laparoscopic sleeve gastrectomy (LSG) may be due to dilation of the gastric reservoir. Laparoscopic re-sleeve gastrectomy (LrSG) is among the revisional surgery options. We aimed to investigate the effectiveness of LrSG for weight loss after a 12- and 24-month follow-up period. Bariatric surgery center in Baku/Azerbaijan. From June 2016 to June 2019, a total of 34 LSG patients with weight regain, underwent LrSG. We prospectively followed outcomes data were BMI changes, excessive weight loss, changes in laboratory values, and the presence of complications. The mean age at revision surgery was 36 ± 7.09 (range, 22–51) years, and the mean body mass index (BMI) before LrSG was 40 ± 5.2 kg/m2. The mean time between the primary and revision surgery was 50 ± 7.8 months. The main reasons for the revisions were weight regain and inadequate weight loss. The mean BMI value decrease at the 12th and 24th months were 27.7 ± 2 and 24.3 ± 1.02, which were statistically significant (p

Objective. To compare the results of the bariatric surgical operations for the 5 year period in patients, suffering obesity among population of Azerbaijan. Маterials and methods. Bariatric surgical operations were performed in 104 patients, suffering obesity among population of Azerbaijan. Average age of the patients was 33.1 years old, and average body mass index (BMI) - 57.5 kg/m2. Comparative analysis of various technical modifications and postoperative complications was conducted. The patients were examined preoperatively and in 1, 3, 6 and 12 mo after the operation. BMI, the signs of diabetes, hypertension, the apnoe syndrome while sleeping and hepatic adipose dystrophy were investigated in dynamics. Results. In 88 (84,6%) patients, in whom a standard laparoscopic sleeve gastrectomy (LSG) was performed, in 6 mo afterwards the body mass have reduced by (39.5 ± 11.5) kg at average. Of 12 (11.5%) patients after gastric shunting in 2 (1.9%) patients a gastric shunting in accordance to Roux method was performed, in 8 (7.6%) - gastric minishunting, 2 (1.9%) - LSG and Roux shunting. As a result, the body mass have reduced by (46 ± 14) kg, аnd during 6-12 mo observation its effective increase was observed by (33.5 ± 8.5) kg at average. In 1 (1%) patient in other clinic the gastric duplication operation was performed. The body mass during the following year have reduced by 20 kg and stopped, so the patient have been applied into our clinic and to him gastrorestrictive operation was performed. His body mass have reduced by 36 kg. In 3 (2.9%) patients, who have gained the body mass in 2 years after the operation, reoperation procedure was LSG. Subsequently in these patients a satisfactory reduction of the body mass was noted. Conclusion. After LSG performance the body mass reduction in patients with severe obesity is mostly satisfactory, the vitamin balance disorders are absent, and dynamics of concurrent pathology is positive, making this procedure mostly secure. Meanwhile after shunting bariatric surgery the abovementioned indices are higher and in presence of diabetes mellitus this procedure is mostly effective. LSG is anatomically and physiologically ideal operation, because in case of ineffective body mass lowering the reoperation is possible, and this operation is feasible in patients without diabetes Type II.

Цель. Изучить корреляцию между контролем уровня гликемии и степенью снижения индекса массы тела у пациентов после бариатрической операции. Материалы и методы. Проведен контроль уровня обмена глюкозы у 84 пациентов с предиабетом и сахарным диабетом 2-го типа, страдающих патологическим ожирением, после операции уменьшения желудка. Результаты. Из 84 пациентов у 30 (35,7%) продолжительность заболевания сахарным диабетом 2-го типа составляла 1 год, у 27 (32,1%) – 10 лет, у 12 (14,3%) - более 10 лет. У 15 (17,9%) пациентов диагностирован предиабет. При изучении антропометрических показателей отмечено снижение массы тела на 38% после операции по сравнению с исходными показателями. Индекс массы тела (ИМТ) снизился с 46,8 (41,3 – 54,3) до 27,6 (25,4 – 30,9) кг/м2 (р = 0,001). Через 2 года после операции общее снижение массы тела по сравнению с исходными показателями составило 42%, а ИМТ снизился до 26,8 (23,1 – 28,4) кг/м2. Ремиссия сахарного диабета 2-го типа в сроки наблюдения 1 - 3 года отмечена у 82 (98,6%) пациентов (уровень гликированного гемоглобина менее 6,0%, глюкозы натощак менее 5,6 ммоль/л). Выводы. Результаты проведенного исследования показали, что продольная резекция желудка у больных с сахарным диабетом 2-го типа эффективна не только для уменьшения ИМТ, но и для коррекции метаболического синдрома. В послеоперационном периоде у них наблюдали стабильность показателей гликемии и углеводного обмена.

Setting: A private Azerbaijan Medical University, Department of Surgical Diseases-I and Modern Hospital Azerbaijan. Objective: To investigate the results of various types of bariatric surgical operations in patients with overweight in the Azerbaijani population. Material and methods: The study involved results of 214 severely obese patients [average age 40 ± 19; average body mass index (BMI) 59.95 ± 20.25 kg/m2] who undergone bariatric surgery, 186 (86.9%) were females and 28 (13%) were males, compared post-operative complications by different technical modification, and observed fatty liver disease dynamics by examining BMI, diabetes, hypertension before operation and 1, 3, 6 and 12 months after operation. Results: During the first 12 months, 195 (91.1%) patients who undergone laparoscopic sleeve gastrectomy (LSG) achieved average weight loss of 66.5+11.5 kg. In 10 (4.7% ) patients who undergone gastric bypass surgery [2 (0.9%) patients-Ru Y gastric bypass, 6 (2.8%) patients-mini gastric bypass, 1 (0.5%) patient-sleeve+Ru Y gastric bypass and 1 (0.5%) patient-sleeve+mini gastric bypass], 9 (4.2%) patients Re-sleeve gastrectomy, Sleeev gastrectomy group this indicator was 76 ± 14 kg, and during the second 6 months effective weight loss was observed as in previous months, which equalled to 33.5 ± 8.5 kg. The bupasse group this indicator was 79 ± 8 kg/Annual weight loss indicator was 71.5 ± 23.5 kg for all surgeries. Conclusion: According to our study, it can be concluded that unlike other methods, satisfactory weight loss in severely obese patients and consequently, improvement in comorbidities observed after laparoscopic sleeve gastrectomy (LSG) make this method more reliable.

Bariatric surgery results in severe obese patients have been reviewed in the Azerbaijani population. The study involved results of the research performed with 119 severely obese patients [average age 40 19; average body mass index (BMI) 59.95+20.25 kg/m²] who undergone bariatric surgery, com- pared post-operative complications by different technical modification, and observed fatty liver dis- ease dynamics by examining BMI, diabetes, hypertension before operation and 1, 3, 6 and 12 months after operation. During the first 6 months, 109 (92.6%) patients who undergone laparoscopic sleeve gastrectomy (LSG) achieved average weight loss of 39.5+11.5 kg. In 10 (8.4%) patients who undergone gastric bypass surgery [2 (1.68%) patients - Ru Y gastric bypass, 6 (5.0%) patients - mini gastric by- pass, 1 (0.84%) patient - sleeve + Ru Y gastric bypass and 1 (0.84%) patient - sleeve+mini gastric by- pass], this indicator was 46±14 kg, and during the second 6 months effective weight loss was observed as in previous months, which equaled to 33.5+8.5 kg. Annual weight loss indicator was 71.5+23.5 kg for all surgeries. According to our study it can be concluded that unlike other methods, satisfactory weight loss in severely obese patients and consequently, improvement in comorbidities observed after laparoscopic sleeve gastrectomy (LSG) make this method more reliable.

This methodical tool, intended for students and residents, includes information on the definition, classification, causes, clinical presentation, diagnosis and treatment approaches of biliary tract injuries, a clinical example and explanatory questions.

This methodical tool intended for students and residents includes theoretical information about liver hemangioma, diagnostic and treatment approach, clinical example, explanatory and test questions.

INTRODUCTIONThere is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can’t be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver.PRESENTATION OF CASEHere we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done.DISCUSSIONCurative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft.CONCLUSIONAlthough living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver.

Kitab əməkdar elm xadimi, əməkdar həkim, Tibb elmləri doktoru, Professor Həsən Abbas oğlu Sultanovun əziz xatirəsinə həsr olunmuşdur. Kitab H. A. Sultanovun həyatı və elmi ya¬ra¬dıcılığını, cərrahlıq elminin, klinik cərrahlığın, xüsusi ilə prak¬tik cərrahi koloproktologiyanın inkişafına alimin böyük töh-fələrini özündə əks etdirmişdir. Alim haqqında, onun həkim¬lik fəaliyyəti və elmi tədqiqatlarının nəticələri barədə həm¬kar¬la¬rının, tələbələrinin səmimi fikirləri, təəssüratları və xoş xatirələri geniş işıq¬lan¬mışdır. Tibb tariximizin çanlı və şanlı əfsənələrindən biri haqqında yazılmış bu kitab onun yaddaşlardan heç zaman silinməyəcək xatirəsinə həmkarlarının və tələbələrinin kiçik hədiyyəsidir.