Kayabali I, Gokcora I H, Yerdel M A, Ormeci N
Department of General and Paediatric Surgery, Ankara University Hospital, Turkey.
Int Surg. 1992 Jul-Sep;77(3):154-7.
This series represents seven cases of hepatic fascioliasis (HF), two diagnosed as the sequelae of the disease and five showing the parasite itself at the time of the primary surgical intervention. The mean history of the symptoms was 42.6 mths. All of the patients were initially misdiagnosed as having cholecysto- and/or coledocho-lithiasis or hepatitis. Definite diagnosis was established intraoperatively in each instant. At surgery cholecystectomy, choledochotomy with extirpation of the flukes from the biliary tree and T-tube biliary drainage was performed without any complications in five patients. The remaining two patients were suffering from recurrent cholangitic episodes and were regarded as sequelae and therefore treated with hepatic peri-arterial neurectomy with favourable results. Six patients received medical treatment involving emetine hydrochloride. Two patients failed to return for follow-up while others were seen to be well 6, 12, 24 mths and 13 and 24 yrs postoperatively, implying promising long-term results both in the active and chronic stages of HF.
本系列报道了7例肝片吸虫病（HF），其中2例诊断为该病后遗症，5例在初次手术干预时发现了寄生虫本身。症状的平均病史为42.6个月。所有患者最初均被误诊为胆囊炎和/或胆总管结石或肝炎。每例均在术中确诊。手术时，5例患者行胆囊切除术、胆总管切开术并从胆管树中取出吸虫，同时行T管胆道引流，无任何并发症。其余2例患者反复出现胆管炎发作，被视为后遗症，因此接受了肝动脉周围神经切除术，效果良好。6例患者接受了含盐酸依米丁的药物治疗。2例患者未返回进行随访，其他患者在术后6个月、12个月、24个月以及13年和24年时情况良好，这表明HF的活动期和慢性期均有良好的长期结果。
