Sayek I, Onat D
Department of Surgery, Hacettepe University School of Medicine, Ankara, Turkey.
World J Surg. 2001 Jan;25(1):21-7. doi: 10.1007/s002680020004.
Hydatid disease of the liver is still endemic in certain parts of the world. The diagnosis of noncomplicated hydatid cyst of the liver depends on clinical suspicion. Ultrasonography and computed tomography, the most important diagnostic tools, are helpful for determining the complications and planning treatment. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy. Surgery is still the treatment of choice and can be performed by the conventional or laparoscopic approach. Percutaneous drainage and treatment of the cyst with hypertonic saline or alcohol seems to be a good alternative to surgery in selected cases. Currently, we treat types I and II by ultrasound-guided percutaneous drainage and types IV and V (excluding totally calcified cysts) surgically. Type III cysts can be managed either way depending on the presence of drainable content. We believe that the laparoscopic approach should be limited to noncomplicated cysts.
肝包虫病在世界某些地区仍然流行。肝单纯性包虫囊肿的诊断依赖于临床怀疑。超声检查和计算机断层扫描是最重要的诊断工具,有助于确定并发症并规划治疗方案。肝包虫囊肿的现代治疗方法从手术干预到经皮引流或药物治疗不等。手术仍然是首选的治疗方法,可以通过传统或腹腔镜手术进行。在某些特定病例中,经皮引流并用高渗盐水或酒精治疗囊肿似乎是手术的一个很好的替代方案。目前,我们对I型和II型囊肿采用超声引导下经皮引流,对IV型和V型(不包括完全钙化的囊肿)采用手术治疗。III型囊肿可以根据是否存在可引流内容物采用任何一种方法处理。我们认为腹腔镜手术应限于单纯性囊肿。