Ormeci N, Soykan I, Bektas A, Sanoğlu M, Palabiyikoğlu M, Hadi Yasa M, Dökmeci A, Uzunalimoğlu O
Division of Gastroenterology, University of Ankara Medical School, Ibn-i Sina Hospital, Ankara, Turkey.
Am J Gastroenterol. 2001 Jul;96(7):2225-30. doi: 10.1111/j.1572-0241.2001.03886.x.
The aims of this study were to investigate the efficacy of a new percutaneous treatment modality of hydatid disease of the liver and to present the results of long term follow-up.
Eighty-seven patients (55 female, mean age 43.5 yr) with 98 hydatid cysts (73 type I, 15 type II, and 10 type III) in the liver underwent percutaneous treatment. All patients were examined by ultrasonography and some of them were examined by CT. They were all positive by indirect hemagglutination test. Sonographic guidance was used in all patients. The procedure included the puncture and free drainage of the cyst fluid. After free drainage was stopped, absolute alcohol and polidocanol 1% were used as sclerosing agents. The patients were followed-up with periodic ultrasonographic examinations.
The mean follow-up time was 33 months. The mean diameter of the cysts decreased from 77.0+/-2.7 mm to 63.0+/-2.5 mm (p < 0.001). The entire cyst cavity filled with a solid echo pattern in 32 cysts, two-thirds of the cyst cavity showed a pseudotumor echo pattern in 34 cysts, and one-third of the cyst cavity showed a pseudotumor pattern in 23 cysts, whereas no pseudotumor appearence was observed in eight cysts. Apart from an anaphylactoid reaction observed in one patient, no major complication occurred during the follow-up period.
Long term results indicate that this new percutaneous treatment modality of the hydatid disease of the liver is an effective and safe method without causing major complications. Percutaneous treatment of hydatid cysts of the liver offers good results and should be the first choice, especially for patients who are contraindicated to surgery.
本研究旨在探讨一种治疗肝包虫病的经皮新治疗方式的疗效，并呈现长期随访结果。
87例肝脏有98个包虫囊肿（73个I型、15个II型和10个III型）的患者接受了经皮治疗。所有患者均接受超声检查，部分患者还接受了CT检查。间接血凝试验均为阳性。所有患者均采用超声引导。该操作包括囊肿液的穿刺和自由引流。自由引流停止后，使用无水乙醇和1%聚多卡醇作为硬化剂。对患者进行定期超声检查随访。
平均随访时间为33个月。囊肿平均直径从77.0±2.7mm降至63.0±2.5mm（p<0.001）。32个囊肿的整个囊腔充满实性回声，34个囊肿的三分之二囊腔显示假瘤回声，23个囊肿的三分之一囊腔显示假瘤回声，而8个囊肿未观察到假瘤表现。除1例患者出现类过敏反应外，随访期间未发生重大并发症。
长期结果表明，这种治疗肝包虫病的经皮新治疗方式是一种有效且安全的方法，不会引起重大并发症。经皮治疗肝包虫囊肿效果良好，应作为首选，尤其是对手术禁忌的患者。
