Ozmen V, Igci A, Kebudi A, Kecer M, Bozfakioglu Y, Parlak M
Department of Surgery, Istanbul School of Medicine, Capa, Turkey.
Can J Surg. 1992 Aug;35(4):423-7.
The results of surgery in 38 patients with hepatic hydatid disease are described. Cystectomy was done in four patients with small peripheral cysts. For them the mean postoperative stay was 8.2 days. Partial cystectomy, introflexion and omentoplasty were performed in 28 patients with uncomplicated large cysts. The mean postoperative stay for these patients was 8.6 days. One patient in this group died of massive hemorrhage and disseminated intravascular coagulation. Exploration of the common bile duct and choledochoduodenostomy were required in three patients who had large cysts complicated by rupture into the biliary tree. This complication resulted in a mean postoperative stay of 11.5 days. Three patients who had cysts complicated by pyogenic infection were treated with tube drainage. They were discharged with their tubes in place after a mean hospital stay of 26.5 days. Hydrogen peroxide 10% was used as a scolicidal agent and was successful in preventing dissemination. All patients underwent ultrasonography 3 months after surgery, and 28 (74%) were followed up by annual examination. There was no recurrence after a mean follow-up of 2.7 years. The results suggest that surgical treatment of hepatic hydatid disease should be governed by the size, location and complications of the cyst. The combination of partial cystectomy, introflexion and omentoplasty was safe and effective therapy for patients with large hepatic cysts uncomplicated by pyogenic infection.
本文描述了38例肝包虫病患者的手术结果。4例小的周边囊肿患者接受了囊肿切除术，他们术后平均住院时间为8.2天。28例无并发症的大囊肿患者进行了部分囊肿切除术、内翻术和网膜成形术，这些患者术后平均住院时间为8.6天，该组中有1例患者死于大出血和弥散性血管内凝血。3例大囊肿合并破裂入胆管树的患者需要探查胆总管并进行胆总管十二指肠吻合术，这种并发症导致术后平均住院时间为11.5天。3例囊肿合并化脓性感染的患者接受了置管引流治疗，平均住院26.5天后带管出院。10%的过氧化氢用作杀头节剂，成功预防了播散。所有患者术后3个月均接受了超声检查，28例（74%）患者接受了年度检查随访。平均随访2.7年后无复发。结果表明，肝包虫病的手术治疗应根据囊肿的大小、位置和并发症来决定。对于无化脓性感染并发症的大肝囊肿患者，部分囊肿切除术、内翻术和网膜成形术联合应用是一种安全有效的治疗方法。
