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肝包虫囊肿的外科治疗

Surgical treatment of hydatid cysts of the liver.

作者信息

Agaoglu N, Türkyilmaz S, Arslan M K

机构信息

Department of General Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

出版信息

Br J Surg. 2003 Dec;90(12):1536-41. doi: 10.1002/bjs.4313.

Abstract

BACKGROUND

Echinococcosis is a zoonotic disease that occurs throughout the world. The purpose of this study was to assess the clinical features and results of surgical treatment of hepatic hydatid cysts.

METHODS

One hundred and two patients operated on between 1991 and 2002 were reviewed retrospectively. The patients' demographic data, location, number and size of cysts, type of surgical procedure performed, morbidity, recurrences and duration of hospital stay were recorded.

RESULTS

There were 74 male and 28 female patients with ages ranging from 15 to over 60 years. The most frequent symptom was abdominal pain. From the total of 136 hepatic cysts, 54 (39.7 per cent) were managed by cystostomy and drainage, 40 (29.4 per cent) by cystostomy and capitonnage, 16 (11.8 per cent) by cystostomy and omentoplasty, 24 (17.6 per cent) by cystectomy and two (1.5 per cent) by left lateral hepatic resection. Postoperative complications were more frequent following cystostomy with omentoplasty (six of 16 patients) compared with cystectomy (none of 18) (P = 0.005). Choledochotomy increased the length of hospital stay in patients having cystostomy and drainage (P = 0.021) and in those having cystostomy with omentoplasty (P = 0.028). Two recurrences were observed.

CONCLUSION

Surgery combined with medical treatment by albendazole is effective in the eradication of hepatic hydatid disease and in the prevention of local recurrence.

摘要

背景

包虫病是一种在全球范围内发生的人畜共患疾病。本研究的目的是评估肝包虫囊肿的临床特征及手术治疗效果。

方法

回顾性分析1991年至2002年间接受手术治疗的102例患者。记录患者的人口统计学数据、囊肿的位置、数量和大小、所施行的手术方式、发病率、复发情况及住院时间。

结果

患者共74例男性和28例女性,年龄范围为15岁至60岁以上。最常见的症状是腹痛。在总共136个肝囊肿中,54个(39.7%)采用囊肿造口引流术治疗,40个(29.4%)采用囊肿造口加囊腔缝合术治疗,16个(11.8%)采用囊肿造口加网膜成形术治疗,24个(17.6%)采用囊肿切除术治疗,2个(1.5%)采用肝左外叶切除术治疗。与囊肿切除术(18例中无并发症)相比,囊肿造口加网膜成形术后的术后并发症更常见(16例中有6例)(P = 0.005)。胆总管切开术增加了接受囊肿造口引流术患者(P = 0.021)和接受囊肿造口加网膜成形术患者(P = 0.028)的住院时间。观察到2例复发。

结论

手术联合阿苯达唑药物治疗对根除肝包虫病及预防局部复发有效。

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