MODERN APPROACHES TO THE TREATMENT OF HEPATIC ECHINOCOCCOSIS AT A HIGH-VOLUME SURGICAL CENTER

Abstract

The development of modern minimally invasive technologies makes it possible to use them for treating patients with the liver damaged by echinococcosis. The study included 303 patients with hepatic echinococcosis who were treated at the Botkin Hospital Surgical Clinic from 2007 to 2021. Conservative therapy was used as the main treatment method in 23 patients, but 11 of them were subsequently operated on. Open echinococcectomy was performed in 22 patients. Pericystectomy was performed in 134 patients by a laparotomy technique, 23 patients underwent laparoscopic pericystectomy or liver resection, 17 patients underwent robot assisted pericystectomy, and 82 patients underwent right hemihepatectomy. Thirteen patients underwent physical effect methods on echinococcus cysts. The evaluation criteria of surgical treatment results were patient age, gender, surgical and anesthetic risks according to the ASA grading and localization of parasitic cysts. We considered the immediate results of surgical interventions such as surgery duration, blood loss, hospitalization period, postoperative complications according to the ClavienDindo classification, and specific complications according to the ISGLS. When comparing the immediate surgical treatment results, minimally invasive surgeries were accompanied by less blood loss, number of postoperative complications, and in-patient day. Laparotomy interventions were associated with complex localization of cysts, as well as previous non-radical surgical interventions. Modern minimally invasive technologies can improve immediate treatment results for patients with hepatic echinococcosis.