Tsimoyiannis E C, Siakas P, Glantzounis G, Tsimoyiannis J C, Karayianni M, Gossios K J
Department of Surgery, G. Hatzikosta General Hospital, Ioannina, Greece.
Int Surg. 2000 Jul-Sep;85(3):234-6.
Knowledge on the viability of hydatid cysts of the liver during operation is important to the surgeon may dictate the peri-operative therapeutic manoeuvre undertaken.
A prospective study was performed on 23 patients with 28 hydatid cysts of the liver to assess whether intracystic pressure (ICP) could predict viability of protoscoleces. All patients received albendazole (10 mg/kg body weight/day) for 5 days pre-operatively. The ICP was measured from the apex of the cyst, after laparotomy, using a 16-G needle connected to a water manometer. After manometry, the cyst contents were aspirated and the viability of protoscoleces assessed by their flame cell activity, motility and ability to exclude 5% aqueous eosin.
The median ICP was 54 +/- 21 cmH2O for 17 viable cysts and zero for 8 non-viable cysts, while 1 additional non-viable cyst and 2 sterilized cysts had high ICP (sensitivity, 100%; specificity, 72%; accuracy, 89%). The median diameter of the viable cysts was 9.3 +/- 3.5 cm and the non-viable cysts 10.7 +/- 2.6 cm. In the right lobe were located 12 viable and 8 non-viable cysts and in the left lobe, 5 viable and 3 non-viable cysts. No significant difference in diameter or ICP were noted between the hepatic lobes.
These findings suggest that the measurement of ICP is a simple, cheap and reliable method for assessment of the viability of hydatid cysts of the liver.
了解肝包虫囊肿在手术期间的活力对于外科医生至关重要，这可能决定术中采取的治疗策略。
对23例患有28个肝包虫囊肿的患者进行了一项前瞻性研究，以评估囊内压（ICP）是否能够预测原头节的活力。所有患者在术前5天接受阿苯达唑（10mg/kg体重/天）治疗。剖腹手术后，使用连接到水柱压力计的16G针头从囊肿顶部测量ICP。测压后，吸出囊肿内容物，并通过原头节的焰细胞活性、运动能力以及排斥5%伊红水溶液的能力来评估原头节的活力。
17个存活囊肿的ICP中位数为54±21cmH₂O，8个非存活囊肿的ICP为零，而另外1个非存活囊肿和2个已灭活囊肿的ICP较高（敏感性为100%；特异性为72%；准确性为89%）。存活囊肿的中位数直径为9.3±3.5cm，非存活囊肿为10.7±2.6cm。右叶有12个存活囊肿和8个非存活囊肿，左叶有5个存活囊肿和3个非存活囊肿。肝叶之间在直径或ICP方面未发现显著差异。
这些发现表明，测量ICP是评估肝包虫囊肿活力的一种简单、廉价且可靠的方法。
