Liver Echinococcosis complicated with Lesions of Bile Ducts in Azerbaijan.

Rauf M Aghayev

doi:10.5005/jp-journals-10018-1183

Abstract

ABSTRACTA total of 302 patients with liver echinococcosis (LE) complicated by lesions of bile duct during 1988 to 2015 were analyzed. The patients were divided into two groups. In the first group, 227 patients were included with lesions of segmental bile ducts in the form of cystobiliary and bilio-bronchial fistulas. In the second group, 75 patients with lesions of hepatic bile were enrolled. Diagnosis of LE and its complications was made by ultrasonography and computed tomography (CT). Surgical treatment included echinococcectomy with complete liquidation of a residual cavity (35.1%), echinococcectomy with suturing (46.0%), external drainage of a residual cavity (7.3%), pericystectomy (8.6%), and resection of a liver (3.0%). Postoperative complications related to operative intervention developed in 29 patients. Lethal outcomes took place in 6 cases (2.0%). The analysis has shown that the form of bile duct lesions, methods of surgical operation for liquidation of hydatid cysts, and its biliary complications had influenced the treatment outcome. More optimal results are received after complete liquidation of residual cavity in different ways and suturing of cystobiliary fistulas during operation. For prevention of complications related to the presence of residual cavity, laser processing of walls of a residual cavity by ozonized 17% hypertonic solution of NaCl was used and this procedure showed obvious (p < 0.05) advantages.How to cite this articleAghayev RM. Liver Echinococcosis complicated with Lesions of Bile Ducts in Azerbaijan. Euroasian J Hepato-Gastroenterol 2016;6(2):125-130.

Highlights

Liver echinococcosis (LE) is a serious parasitic disease, which remains a serious medical and economic problem in many countries around the world, including Azerbaijan.[1,2,3] Azerbaijan is included among the countries with high incidence of LE.[4]
The presented work is based on the retrospective analysis of surgical treatment of 302 patients with LE, complicated by lesions of bile ducts, which were operated at Scientific Center of Surgery, Azerbaijan Medical University during the period from 1988 to 2015
The surgical method was determined from the number and location of cysts, their connection with bile ducts, and the presence of preoperative complications

Summary

Introduction

Liver echinococcosis (LE) is a serious parasitic disease, which remains a serious medical and economic problem in many countries around the world, including Azerbaijan.[1,2,3] Azerbaijan is included among the countries with high incidence of LE (about 1 patient per 5000–10000 inhabitants).[4] Despite considerable achievements in liver surgery, the number of patients affected does not tend to decrease. As a result of late diagnosis, surgical treatment is needed in considerable numbers of patients and postoperative lethality may reach as high as 5 to 10%.1,5,6. One of the most dangerous complications of the LE is a rupture of cysts in bile ducts. There is paucity of information on bile ducts lesions in patients with LE and it may vary from 1.3 to 55%.7-9. Sooner or later, 90% of all liver hydatid cysts are complicated by bile duct lesions.[10] There is paucity of information on bile ducts lesions in patients with LE and it may vary from 1.3 to 55%.7-9 According to some researchers, sooner or later, 90% of all liver hydatid cysts are complicated by bile duct lesions.[10]

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