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Introduction. Massive blood loss while performing resections of the liver continues to be a serious problem with potentially lethal outcome. Therefore in the last 2-3 decades there has been a significant developement of techniques for vascular control during liver resections. Methods. In the period from 01.01.2006 to 31.12.2015 in KOCPH UMBAL "Aleksnadrovska" a total of 239 patients with colorectal liver metastases underwent surgery of whom: 179 patients were radicaly operated on and 57 patients were subjected to Pringle maneuver. Using the statistical software SPSS-19 we analyzed various factors that may affect the early postoperative results. Results. In resections of colorectal liver metastases there was a significant difference in the postoperative functional parameters (AST, ALT), which correlated with the degree of liver damage, in patients with Pringle and without Pringle maneuver 265.32 vs. 448 (p = 0.001), and 300.53 vs. 481.91 (p = 0.002),- respectively. There was no significant difference in the postoperative results in comparisson of resections < 15 minutes, performed without Pringle and with Pringle maneuver. The blood loss is another factor that affects the postoperative complications (p = 0.048), and it was lowest in the Pringle group

Introduction: Colorectal liver metastases have a poor prognosis and only 2% have an average 5 - year survival if left untreated. In recent decades there has been a development in the diagnosis, treatment and palliative treatment of patients with colorectal liver metastases, and despite radical resection the average five-year survival is between 25% and 44%. Aim: To explore the experience of the Clinic in the treatment of colorectal liver metastases, comparing it with data from the literature and based on the comparison to determine the prognostic factors that affect survival after radical surgical treatment of patients. Methods: A retrospective study was conducted at the Clinic of General and Hepato - pancreatic Surgery at the University Hospital "Aleksandrovska" - Sofia. The study comprised the period between 01.01.2006 to 31.12.2015. It included a total of 239 cases, of whom: 179 patients underwent radical interventions, 5 palliative and 55 patients underwent explorative interventions due to liver metastases. Clinical and pathological materials were analyzed using SPSS- 19 to determine the prognostic significance of a number of factors in relation to the survival: gender, age, type and localization of metastases, postoperative stage of the primary tumor, type and volume of liver resection, extrahepatic metastases, preoperative values of CEA, postoperative values (AST, ALT). Results: Factors that correlated with lower survival type: metastases (synchronous or metachronus), localization of metastases (uni- or bilobar), presence of the regional lymph node metastases and metastases to other distant organs and the impossibility of radical resection of liver were statistically significant with multivariant analysis. Elevated preoperative value of CEA, the value of hemoglobin and stage IV disease also affected the survival of patients. Conclusion: In patients with colorectal liver metastases only resection has potentially curative character. The surgical strategy for resection in context of increasing the percentage of patients with resectable potential is the only possible factor for long-term survival. Keywords: colorectal metastases, radical resections, prognostic factors, survival, stage of the disease