The choice of treatment of patients with liver echinococcosis in children

Abstract

For the Article by Salimov Sh. T. as co-author on the topic: “The choice of treatment in patients with hepatic echinococcosis in children”. The article analyzes the results of treatment of 96 patients aged 3 to 18, who underwent laparoscopic echinococcectomy between 2007 and 2015. Solitary echinococcosis was detected in the liver of 66 (68.8 %) patients, multiple (two or more cysts) — in 30 patients (31.2 %). A total of 147 echinococcus cysts were removed. Of the 96 taken laparoscopic liver echinococcectomy in 7 (7.3 %) cases due to intrahepatic localization of the cyst and due to technical difficulties, conversion was required. Residual cavities located in the anterior segments of the liver — were laparoscopically sutured inside. Rigid RC (residual cavities) of IV–V liver segments in the vicinity of the gate of the liver and gall bladder were dabbed with greater omentum. Fibrous capsule of residual cavity of visceral surface of the liver was excised circularly within the liver tissue and external drainage was performed. Medium and large size of the residual cavity of VI–VII and VIII segments of the liver, after excision of the fibrous capsule was drained as well. In fine and small residual cavity of echinococcus cyst was performed laparoscopic coagulation of the inner wall of the fibrous capsule with abdominization without drainage.In 89 (92.7 %) patients after laparoscopic liver echinococcectomy postoperative period was much more favorable than after traditional echinococcectomy. Patients intensified by the end of 1–2 days. 5 (5.2 %) patients had bile leakage on drainage, which independently docked at 8–11 day, suppuration of the residual cavity was observed in — 3 (3.1 %), non-parasitic cyst formation in the late period was observed in 7 (8.3 %) patients. The average hospital stay in the postoperative period was 6.5 ± 0.5 bed days. Laparoscopic elimination of residual cavity at echinococcectomy liver with kapitonnage, external drainage, abdominization, omentoplasty methods is accompanied by a significant attenuation of the cavity and extends the subsequent elimination of the residual cavity.