当前位置: X-MOL 学术HPB › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Surgical management of hepatic hydatid cysts – conservative versus radical surgery
HPB ( IF 2.7 ) Pub Date : 2020-03-28 , DOI: 10.1016/j.hpb.2020.03.003
Kunal B Deo 1 , Rahul Kumar 2 , Govinda Tiwari 2 , Hemanth Kumar 2 , Ganga R Verma 1 , Harjeet Singh 1
Affiliation  

Background

Surgical management is considered one of the effective treatment modality for liver hydatid. However the choice of surgery is debatable. This study aims to compare the outcome of radical surgery (RS) and conservative surgery (CS) in liver hydatid disease.

Methods

This is retrospective analysis of prospectively maintained institutional data of surgically treated liver hydatid from January 2012 to January 2019. The basis of diagnosis was typical imaging, confirmatory Hydatid serology and/or Intraoperative details. The clinical presentation, radiological data, operative detail, post-operative outcome, post-operative recurrence data was analysed.

Results

Sixty-four patients underwent surgery during the study period and were included. RS was done in 27 (42.2%) patients and CS in 37 (57.8%) patients. The mean age was 35.6 (13–72) years. The mean size of the cyst was 10.3 ± 2.9 cm. The cyst location was peripheral in 81.5% and 56.8% in RS and CS groups respectively. Intraoperative Cyst biliary communication was detected in 48.1% of RS & 35.1% in CS group of patients. The post-operative bile leak was significantly less in RS group (7.4% vs 27.0%, p = 0.047). Postoperative endoscopic stenting for persistent biliary fistula was necessitated in five of CS and only one patient from RS group. None of RS patients had recurrence while 3 patients of CS developed recurrence.

Conclusion

Radical surgery reduces post-operative bile leak and prevents recurrence and may be preferable to conservative surgery.



中文翻译:

肝包虫囊肿的手术治疗——保守手术与根治手术

背景

手术治疗被认为是肝包虫的有效治疗方式之一。然而,手术的选择是有争议的。本研究旨在比较根治性手术(RS)和保守性手术(CS)治疗肝包虫病的结果。

方法

这是对 2012 年 1 月至 2019 年 1 月手术治疗的肝包虫的前瞻性维护机构数据的回顾性分析。诊断基础是典型的影像学、确诊的包虫血清学和/或术中细节。分析了临床表现、放射学数据、手术细节、术后结果、术后复发数据。

结果

64 名患者在研究期间接受了手术并被纳入研究。RS 在 27 (42.2%) 名患者中进行,在 37 (57.8%) 名患者中进行了 CS。平均年龄为 35.6 (13-72) 岁。囊肿的平均大小为 10.3 ± 2.9 cm。RS组和CS组的囊肿位置分别为81.5%和56.8%。48.1% 的 RS 和 35.1% 的 CS 患者在术中检测到囊肿胆道交通。RS 组的术后胆漏显着减少(7.4% 对 27.0%,p = 0.047)。5 例 CS 和 RS 组仅 1 例患者需要对持续性胆瘘进行术后内镜支架置入术。RS 患者无复发,而 CS 患者有 3 例复发。

结论

根治性手术可减少术后胆漏并防止复发,可能优于保守手术。

更新日期:2020-03-28
down
wechat
bug