Abstract
purpose of this study is to evaluate the results and role of radical operations in the management of hepatic hydatid disease. 317 patients with liver hydatid cysts underwent surgical treatment. Liver resection, total and subtotal pericystectomy were possible in 215 patients (67,8%). There were 115 patients (36,3%) with complicated hepatic hydatid cysts. Residual echinococcosis was indication for operation in 17%. Among all patients 53 (16,7%) presented other anatomic sites of parasite such as lung, peritoneum, kidney, and other viscera. The postoperative complication rate was 25,7% after operations without pericystectomy, 17,6% - after radical operations and 19,8% - after combined operations. The mortality rate was 1,6%. The recurrence rate was 6,7%. Removal of cystic and pericystic tissue and liver resection are the only type of operations for safe and radical treatment of liver hydatid cysts, especially in the cases of complicated and relapsing disease.
Highlights
В последнее десятилетие отмечается рост заболеваемости эхинококкозом, увеличение доли осложненного течения заболевания
The purpose of this study is to evaluate the results and role of radical operations in the management of hepatic hydatid disease. 317 patients with liver hydatid cysts underwent surgical treatment
Total and subtotal pericystectomy were possible in 215 patients (67,8%)
Summary
Представлен анализ результатов хирургического лече ния 317 больных эхинококкозом печени, проходивших лече ние в Институте хирургии им. Для дифференциальной диагностики эхинококкоза и непаразитарных кист печени у ряда больных с тонкостенными эхинококковыми кистами, со ответствовавшими I и I-а типам по классификации M. Последний вид операций подразумевает сочета ние радикальных и условно-радикальных вмешательств со способами эхинококкэктомии без удаления фиброзной обо лочки в случаях множественного поражения печени с труд нодоступной локализацией части кист, радикальное удале ние капсулы которых резко повышает риск осложнений. Та ким образом, операции с максимально возможным удалени ем фиброзной капсулы выполнены у 215 (67,8%) больных. Операции без удаления фиброзной капсулы использо вались в основном на ранних этапах освоения хирургическо го лечения эхинококкоза. 1. Распределение больных в зависимости от вида хирургического лечения эхинококкоза печени
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