TISSUE SPARING TECHNIQUE IN LIVER HYDATID DISEASES: THREE-WAY TECHNIQUE VERSUS HYDATID CONE TECHNIQUE

Abstract

Echinococcosis (known as hydatid disease or hydatidosis) is a serious, sometimes fatal, zoonoticdisease caused by Echinococcus two species. E. granulosus, causes worldwide cystic echinococcosis(hydatidosis) maintained in domestic transmission cycle involving dogs and livestockmainly sheep, and E. multilocularis, causes alveolar echinoccososis endemic in the northern hemispherein wild transmission cycle involving dogs and wild carnivores and rodents. Intermediatehosts including man are infected by ingestion of eggs dropped from dog with food, fluidor fingers, or by crawling insects from site of fecal deposition. Eggs hatch in gut into invasiveoncospheres, which penetrate intestinal mucosa, enter venous and lymphatic pathways. Theseoncospheres according to species developed into unilocular or classical hydatid disease or cysticechinococcosis, with few years’ incubation period or infiltration into alveolar or multilocularechinoccososis with 10-30 years incubation period. The clinical pictures of E. granulosus wereusually from asymptomatic to fatal. But, alveolar echinoccososis particularly in the liver becomesmetastatic and is frequently fatal. Chemotherapies (albendazole, mebendazole or praziquantil)may be of value prior to surgery or in inoperable cases, but alveolar cysts may require bothsurgery and prolonged chemotherapeutic treatment.Liver surgery has gone through the phases of wedge liver resection, regular resection of heapticlobes, irregular and local resection, extracorporeal hepatectomy, hemi-extracorporeal hepatectomyand others. Taking the modern technologies advantage, the liver surgery is stepping intoan age of precise liver resection.