Surgery of ruptured human hepatic cystic echinococcosis
10.3760/cma.j.issn.1007-631X.2010.04.003
- VernacularTitle:肝囊型包虫破裂的外科治疗110例
- Author:
Hao WEN
;
Binyu QIU
;
Aili TUERGAN
;
Yingmei SHAO
;
Jinming ZHAO
;
Haitao LI
;
Bo RAN
- Publication Type:Journal Article
- Keywords:
Echinococcosis,hepatic;
Surgical procedure,operative;
Rupture
- From:
Chinese Journal of General Surgery
2010;25(4):273-276
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the evolution of surgical treatment and it's influence on prognosis in reptured liver cystic echinococcosis.Method Clinical data of 110 surgically treated cases of reptured liver cystic echinococcosis from January 1990 to December 2008 were retrospectively analysed,and these cases were divided into three groups by different surgical approach;Group A(22 cases):removal of internal capsule,with formaldehyde or hydrogen peroxide regional anthelminthic,with residual cavity side edge of lock stitching or greater omentum filling or drainage after residual cavity closure;Group B (65 cases):Removal of intemal capsule,with hypertonic saline regional anthelminthic,with external capsule extrahepatic partial resection,with residual cavity bile leakage sutured,and with residual cavity open drainage,Group C(23 cases):the total or subtotal external capsule stripping operation,with hypertonic saline regional anthelminthic and drainage.Result The rate of overall postoperative complications of residual cavity was 40.9%、16.9%、0.0%(P<0.05)respectively and the recurrence rate was 18.2%、4.6%、0.0%(P<0.05)respectively;drainage time needed was the longest in group A,and shortest in group C,whereas the operation time was the longest in group C and it costed higher blood loss.Intraabdominal implantation of the hydatid significantly decreased with hypertonic saline treatment.Conclusion Total or near total removal of the external capsule of the hydatic cyst and hypertonic saline treatment with postoperative external drainage is the therapy of choice for reptured liver cystic echinococcosis.