РЕЗУЛЬТАТЫ ЭФФЕКТИВНОСТИ ЛАПАРОСКОПИЧЕСКОГО ЛЕЧЕНИЕ ЭХИНОКОККОЗА ПЕЧЕНИ

Abstract

Laparoscopic surgery for liver echinococcosis is a technical option in individual uncomplicated cases of the disease, and the risk of complications after laparoscopy, especially leakage of the contents of the echinococcal cyst, has not been evaluated in larger interinstitutional studies. The purpose of this study: to study the results of laparoscopic treatment of liver echinococcosis with the identification of factors that affect specific aspects of the effectiveness of surgical approaches depending on the localization, size and stage of development of the cyst. Methods. Laparoscopy in the comparison group was performed only in patients with the primary form of liver echinococcosis – 46 patients; solitary cyst was in 26 (56.5%) cases and multiple cysts in 20 (43.5%) patients. Results. The technical aspects of performing laparoscopic echinococcectomy play a leading role in the effectiveness of the technique. Taking into account the stage of cyst development, various difficulties with manipulations occurred more often in type II-IV CE. Thus, difficulties with aspiration or removal of cyst contents were noted in only 14 (30.4%) cases, while for type CE II this indicator was 50% (6 out of 12 patients), for CE III – 44.4% (in 4 out of 9 patients), for type IV – 100% (3). Conclusions. Thus, among the main factors technically complicating laparoscopic echinococcectomy, in addition to localization, difficulties with aspiration or removal of cyst contents were identified in 54.2% of cases at the stage of development - CE II, III and IV (in 13 out of 24 patients with these types) due to the presence of many daughter cysts completely filling the mother shell (CE II, III) or thick viscous discharge (CE IV), as well as difficulties with performing perekistectomy for adequate abdominization of the residual cavity with the location of the hydatid 3/4 or more in the liver parenchyma - 19.6% (in 9 of all 46 operated).