Current trends in surgical treatment of liver echinococcosis
Abstract
The choice of the optimal method of surgical treatment of hepatic echinococcosis continues to be a subject of debate in the surgical community. Despite the historical priority of organ-preserving approaches, radical methods of surgical intervention on the liver have been actively developed and introduced into clinical practice in recent years. The purpose of the study was to analyse the immediate and long-term results of the use of organ-preserving and radical surgical interventions in hepatic echinococcosis. 362 patients with hydatid echinococcosis of the liver were examined. Of these, 302 (75.8%) had primary echinococcosis and 60 (24.2%) had recurrent echinococcosis. There were 179 men (49.5%) and 183 women (50.5%). Conventional surgical procedures were performed in 232 (64.1%) patients with hepatic echinococcosis. With conventional echinococcectomy, postoperative mortality was 0.9%, postoperative complications developed in 47 patients, which was 20.3%, and disease recurrence was observed in 11 (4.7%) patients. The most frequently observed residual cavity after echinococcectomy was in 29 (12.4%) patients, including suppuration of the residual cavity in 10 (4.3%) patients. Radical surgical treatment of hepatic echinococcosis was performed in 130 patients, of whom 2 (1.5%) died. After radical surgery, specific complications were noted in 18 patients, which amounted to 13.8%. The most common complications were haemorrhagic and biliary complications, which were detected in 9 patients. Intra-abdominal bleeding occurred in 5 patients, of which 4 had less intense bleeding and was stopped after haemostatic therapy, and one patient underwent a relaparatomy and bleeding was stopped early after surgery. Liver failure developed in two patients who underwent liver resection and combined operations, which were corrected with drug treatment. Radical operations with removal of the fibrous capsule with all pericystic liver tissues (pericystectomy and resection) contribute to improving the immediate and long-term results of surgical treatment of echinococcosis
Keywords:
echinococcosis; antisepsis; echinococcectomy; resection; pericystectomy; relapse preventionReferences
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