[Sucking effect of diaphragm and its significance in drainage of abdominal cavity during hepatic surgery].
Investigation of the value of the sucking effect of the diaphragm in 44 patients was carried out. The first group consisted of 28 patients who have not undergone hepatic resection. The second group included patients after hepatic resections of various volume in local pathology. The balloon method in modification of this clinic was used for measurement of the value of the sucking effect. In patients of the first group the value of sucking effect was almost two times more under the right cupula of the diaphragm (130.33 + 4.78 mm of water column) in comparison with the left infradiaphragmatic space. It is responsible for presence of the slot between the right half of the liver and the diaphragm, which aggravates the sucking effect. In the second group of patients the value of the sucking effect under the right diaphragmatic cupula was practically the same as in patients of the first group. After right-sided hemihepatectomy the value of the sucking effect under right cupula of the diaphragm has significantly diminished. After resection of the right lobe of the liver as well as after left-sided hemihepatectomy, or without them, the value of sucking effect under left cupula of the diaphragm did not significantly differ. The investigations showed that vacuum-aspiration with vacuum of not less than 150 mm water column should be used for effective drainage of infradiaphragmatic space.