CURRENT APPROACHES IN THE TREATMENT OF LIVER HYDATID ECHINOCOCCOSIS

H. Harutyunyan; H. Barseghyan; A. Voskanyan; A.A. Harutyunyan; A.S. Chopikyan; A.E. Tadevosyan

doi:10.54890/.v2i2.1335

H. Harutyunyan H. Barseghyan A. Voskanyan A.A. Harutyunyan A.S. Chopikyan A.E. Tadevosyan

DOI:

https://doi.org/10.54890/.v2i2.1335

Abstract

This research aimed to enhance the efficacy of surgical treatment for liver echinococcosis by incorporating cutting-edge technologies. Over a decade, 213 patients underwent surgery at the "Astghik" Medical Center, with 43 individuals presenting complicated forms of the disease. The patients were divided into two groups: the first undergoing open echinococcectomy (159 patients), and the second undergoing closed echinococcectomy using advanced equipment (54 patients).
The study provided comprehensive insights into patient demographics, concomitant diseases, and diagnostic methods, emphasizing the importance of serological reactions for accurate diagnosis. Notably, the second group's closed echinococcectomy demonstrated superior outcomes, including shorter treatment durations, reduced postoperative bleeding, and fewer complications compared to the open surgery group. Furthermore, the recurrence rate in the closed echinococcectomy group was significantly lower, highlighting its efficacy in preventing disease relapse.
Postoperative care and outcomes were meticulously examined, showcasing that patient in the closed echinococcectomy group experienced quicker recovery and fewer complications, leading to a higher rate of complete recovery upon discharge. The study also addressed the financial aspect, emphasizing the cost-effectiveness of the closed echinococcectomy approach, reducing financial burdens associated with antiparasitic drug treatment.
In conclusion, the research underscores the benefits of closed echinococcectomy, recommending its preference whenever possible due to its effectiveness in preventing complications, reducing recurrence rates, and optimizing postoperative recovery, all contributing to improved patient outcomes.

Keywords:

liver echinococcus, ideal echinococcectomy, Surgical Treatment, Closed Echinococcectomy, Postoperative Complications, Concomitant Diseases.

Author Biographies

H. Harutyunyan, Yerevan State Medical University

Department of General Surgery

H. Barseghyan, Yerevan State Medical University

Department of General Surgery

A. Voskanyan, Yerevan State Medical University

Department of Endoscopic and Endocrine Surgery

A.A. Harutyunyan, Yerevan State Medical University

Department of Public Health and Healthcare Organization

A.S. Chopikyan, Yerevan State Medical University

Department of Public Health and Healthcare Organization

A.E. Tadevosyan, Yerevan State Medical University

Department of Public Health and Healthcare Organization

References

1. Вафин А.З. Общие принципы апаразитарности и антипаразитарности хирургии эхинококкоза. Анналы хирургической гепатологии. 2005;10(2):105. [Vafin AZ. General principles of aparasitarnosti and antiparasitarnosti surgery of echinococcosis. Annals of Surgical Hepatology. 2005;10(2):105. (In Russ.)].

2. Мусаев Г.Х., Лигоньков Ю.А., Харнас С.С., Бронштейн A.M., Лотов А.Н. Химиотерапия в лечении больных эхинококкозом. Анналы хирургической гепатологии. 2002;7(1):323. [Musaev GX, Ligonykov YA, Kharnas SS, Bronshteyn AM, Lotov AN. Chemotherapy in the treatment of patients with echinococcosis. Annals of Surgical Hepatology. 2002;7(1):323. (In Russ.)].

3. Aeberhard P, Fuhrimann R, Strahm P, Thommen A. Surgical treatment of hydatid disease of the liver an experience from outside the endemic area. Hepatogastroenterology. 1996;43(9):627-636.

4. Sabau D, Draghincescu M, Iugulescu M, et al. Hepatic hydatid cyst in minimally invasive surgery. Chirurgia (Bucur). 1997;92(1):59-65.

5. Шульга Л.Ф., Вдовин Р.П., Ленартович А.К. Наблюдение эхинококкоза печени у ребенка. Клин. хир. 1990;6:56. [Shulga LF, Vdovin RP, Lenartovich AK. Observation of echinococcosis of the liver in a child. Clinical Surgery. 1990;6:56. (In Russ.)].

6. Аллабергенов А.Т., Алиев М.М., Гафуров A.A. Малоинвазивные хирургические вмешательства при осложненных остаточных полостях после эхинококкэктомии печени у детей. Детская хирургия. 2002;1:23-25. [Allabergenov AT, Aliev MM, Gafurov AA. Minimally invasive surgical interventions for complicated residual cavities after hepatic echinococcectomy in children. Pediatric Surgery. 2002;1:23-25. (In Russ.)].

7. Дурумбетов Е.Е., Жетибаев Б.К., Абдрахманова Г.А., Ордабеков С.О. Эхинококкоз в южных областях Казахстана. Материалы республиканской конференции «Эхинококкоз и очаговые заболевания паренхиматозных органов человека». Шымкент. 1998:47-49. [Durumbetov EE, Zhetibaev BK, Abdrakhmanova GA, Ordabekov SO. Echinococcosis in the southern regions of Kazakhstan. Proceedings of the Republican Conference «Echinococcosis and Focal Diseases of the Parenchymatous Organs of Man». Shymkent; 1998:47-49. (In Russ.)].

8. Ордабеков СО. Хирургическое лечение осложненного эхинококкоза органов брюшной полости [Диссертация]. Алматы; 1997. 226 с. [Ordabekov SO. Surgical treatment of complicated echinococcosis of the abdominal organs [Dissertation]. Almaty; 1997. 226 p. (In Russ.)].

9. Becker K, Frieling T, Saleh A, Haussinger D. Resolution of hydatid liver cyst by spontaneous rupture into the biliary tract. J Hepatol. 1997;26(6):1408-1412.

10. Morris DL. Echinococcosis of the liver. Gut. 1994;35(11):1517-1518.

11. Ozmen V, Igci A, Kebudi A, et al. Surgical treatment of hepatic hydatid disease. Can J Surg. 1992;35(4):423-427.

12. Ulualp KM, Aydemir I, Senturk H, et al. Management of intrabiliary rupture of hydatid cyst of the liver. World J Surg. 1995;19(5):720-724.

13. Абдрахманова Г.А. Особенности эпидемиологии эхинококкоза и некоторые вопросы борьбы и профилактики эхинококкозов на юге Казахстана [Автореф. дис.]. Алматы; 2000. 26 с. [Abdrakhmanova GA. Features of the epidemiology of echinococcosis and some issues of the fight and prevention of echinococcosis in the south of Kazakhstan [Dissertation Abstract]. Almaty; 2000. 26 p. (In Russ.)].

14. Акматов Б.А. Эхинококкоз. Бишкек; 1994. 186 с. [Akmatov BA. Echinococcosis. Bishkek; 1994. 186 p. (In Russ.)].

15. Геллер И.Ю. Эхинококкоз. Москва; 1989. 206 с. [Geller IY. Echinococcosis. Moscow; 1989. 206 p. (In Russ.)].

16. Ордабеков С.О., Акшулаков С.К., Кулакеев О.К. Эхинококковая болезнь. Алматы: Эверо. 2009; 512 с. [Ordabekov S.O., Akshulakov S.K., Kulakeev O.K. Ekhinokokkovaya bolezn' (Hydatid disease). Almaty: Evero. 2009; 512 p. (In Russ.)].

17. Дадвани С.А., Шкроб О.С., Лотов А.Н., Мусаев Г.Х. Лечение гидатидного эхинококкоза. Хирургия. 2000;8:27-32. [Dadvani SA, Shkrob OS, Lotov AN, Musaev GX. Treatment of hydatid echinococcosis. Surgery. 2000;8:27-32. (In Russ.)].

18. Huang L, Zheng B, Aduo, et al. Association between radical versus conservative surgery and short-term outcomes of hepatic cystic echinococcosis in Nyingchi, China: a retrospective cohort study. BMC Surg. 2023;23:126. https://doi.org/10.1186/s12893-023-02000-y

19. Kaplan M. Laparoscopic Versus Open Surgery for the Management of Cystic Echinococcosis of the Liver. NIH. US National Library of Medicine. Available from: https://clinicaltrials.gov/ct2/show/NCT01643018