Chautems Roland, Buhler Leo, Gold Benjamin, Chilcott Michael, Morel Philippe, Mentha Gilles
Department of Surgery, University Hospital, Geneva, Switzerland.
Swiss Med Wkly. 2003 May 3;133(17-18):258-62. doi: 10.4414/smw.2003.10168.
The liver is the organ most frequently infected by hydatid disease and medical therapy alone is ineffective in eliminating the parasite. Surgical options vary from complete resection (e.g. total pericystectomy or hepatectomy) to limited procedures (e.g. percutaneous aspiration or unroofing of cysts). The aim of this study was to determine the long-term outcome after complete or partial resection of liver hydatid cysts.
Between 1980 and 1996, 78 patients were operated upon at our institution for liver hydatid cysts. In Group 1, complete resection was achieved in 57 patients (73 %), whereas in Group 2, incomplete resection was performed in 21 patients (27 %), due to multiplicity, bilaterality of cysts or close contact between a cyst and portal or hepatic veins. The post-operative morbidity in Groups 1 and 2, was 31 % and 47 % (N.S.), respectively. Mean duration of hospital stay was 17 and 26 days (p=0.004), respectively. Recurrence rate of hydatid disease after a mean follow-up of 6.6 years was 0 % and 12% (N.S.), respectively. There was no mortality in either group.
Complete surgical resection of hepatic hydatid disease should be attempted whenever possible. Our results, with a mean follow-up of 6.6 years, indicate limited post-operative debilitating complications, low recurrence rate and no mortality.
肝脏是最常受包虫病感染的器官,单纯药物治疗无法有效清除寄生虫。手术方式从完全切除(如全囊肿切除术或肝切除术)到有限手术(如经皮穿刺抽吸或囊肿开窗术)不等。本研究的目的是确定肝包虫囊肿完全或部分切除后的长期疗效。
1980年至1996年间,我院对78例肝包虫囊肿患者进行了手术。第1组中,57例患者(73%)实现了完全切除,而在第2组中,21例患者(27%)由于囊肿多发、双侧性或囊肿与门静脉或肝静脉紧密相连而进行了不完全切除。第1组和第2组的术后发病率分别为31%和47%(无统计学差异)。平均住院时间分别为17天和26天(p = 0.004)。平均随访6.6年后,包虫病的复发率分别为0%和12%(无统计学差异)。两组均无死亡病例。
只要有可能,应尝试对肝包虫病进行完全手术切除。我们的结果,平均随访6.6年,显示术后致残并发症有限,复发率低且无死亡病例。