Alonso Casado O, Moreno González E, Loinaz Segurola C, Gimeno Calvo A, González Pinto I, Pérez Saborido B, Paseiro Crespo G, Ortiz Johansson C
General and Digestive Surgery Department, and Abdominal Organ Transplant Unit, Hospital 12 de Octubre, Madrid, Spain.
Hepatogastroenterology. 2001 Jan-Feb;48(37):235-43.
BACKGROUND/AIMS: As there is still no effective parasiticide, treatment of hydatid cysts continues to be surgical. The possibility of treatment by PAIR. (puncture-aspiration-instillation-reaspiration) or laparoscopy has intensified the debate on the need for radical surgery. This study aims to show that radical surgical resection of the hepatic hydatid cyst is a safe and very effective technique, based on our results after 22 years of experience.
Between 1974 and 1996 in 2 large Madrid hospitals we operated on 459 patients with 630 hydatid cysts. As technical advances and experience may vary results, patients were divided into 2 groups according to the period when they had undergone surgery: group A between 1974 and 1984; and group B between 1985 and 1996. Results of radical surgical resection and changes over the course of evolution of this technique were analyzed.
A progressive drop was observed in morbidity and mortality. There were no deaths related to technical complications amongst total cystopericystectomy cases. Between 1990 and 1996 mortality was 0%, 2% of patients presented biliary fistula and 4% infection of the residual cavity. Mean hospital stay was 15.2 days. Only 1 patient of the 459 presented recurrence.
As regards morbidity and mortality, technical advances and accumulated experience permit safe treatment of hepatic hydatid cysts by radical resection, with an almost nil recurrence rate. This makes it the technique of choice over others such as partial resection, PAIR or laparoscopy.
背景/目的：由于目前仍没有有效的杀寄生虫剂，肝包虫囊肿的治疗仍以外科手术为主。经皮穿刺抽吸注入再抽吸术（PAIR）或腹腔镜手术治疗的可能性加剧了关于根治性手术必要性的争论。本研究旨在根据我们22年的经验结果表明，肝包虫囊肿的根治性手术切除是一种安全且非常有效的技术。
1974年至1996年间，我们在马德里的两家大型医院对459例患有630个肝包虫囊肿的患者进行了手术。由于技术进步和经验可能会使结果有所不同，根据患者接受手术的时间将其分为两组：A组为1974年至1984年；B组为1985年至1996年。分析了根治性手术切除的结果以及该技术在发展过程中的变化。
观察到发病率和死亡率逐渐下降。在全囊肿外囊切除术病例中，没有与技术并发症相关的死亡。1990年至1996年间，死亡率为0%，2%的患者出现胆瘘，4%的患者出现残腔感染。平均住院天数为15.2天。459例患者中只有1例复发。
就发病率和死亡率而言，技术进步和积累的经验使根治性切除能够安全地治疗肝包虫囊肿，复发率几乎为零。这使其成为优于其他治疗方法（如部分切除术、PAIR或腹腔镜手术）的首选技术。
