Safioleas Michael, Stamoulis Ioannis, Theocharis Stamatios, Moulakakis Konstantinos, Makris Sotirios, Kostakis Alkiviadis
Second Department of Propedeutic Surgery, Medical School University of Athens, Laiko General Hospital, 17 Ag. Thoma str., GR 115 27, Athens, Greece.
J Hepatobiliary Pancreat Surg. 2004;11(5):352-6. doi: 10.1007/s00534-004-0915-6.
Hydatid disease is endemic in Greece, and has been known from Hippocrates' time to cause cysts in the liver. We report here three very rare cases of primary gallbladder hydatid disease without prior history or evidence of concurrent disease activity in any other location. To our knowledge, only two previous reports exist, each of one patient suffering from primary gallbladder hydatid disease. Unlike the insidious hydatid cysts of the liver, gallbladder hydatidosis in our patients was associated with early diagnosis, due to gallbladder dysfunction symptoms presenting early in its course. Moreover, the size of gallbladder cysts compared to liver cysts at diagnosis was small (maximal diameter, <5 cm), making total cyst excision along with cholecystectomy feasible for all of our patients. During long-term follow up of the patients (up to 10 years), no disease recurrences were noted. We provide supporting evidence that primary gallbladder hydatidosis presents a different pathophysiological and clinical course, having better prognosis, when compared with the usual liver disease.
包虫病在希腊呈地方性流行,自希波克拉底时代起就已知其可在肝脏形成囊肿。我们在此报告三例非常罕见的原发性胆囊包虫病病例,这些患者既往无任何其他部位并发疾病活动的病史或证据。据我们所知,此前仅有两篇报道,各报道了一例原发性胆囊包虫病患者。与隐匿性的肝包虫囊肿不同,我们患者的胆囊包虫病因在病程早期出现胆囊功能障碍症状而得以早期诊断。此外,与诊断时的肝囊肿相比,胆囊囊肿的大小较小(最大直径<5 cm),这使得对所有患者实施囊肿全切术并同时行胆囊切除术成为可能。在对患者进行长达10年的长期随访期间,未发现疾病复发。我们提供了支持性证据,表明与常见的肝脏疾病相比,原发性胆囊包虫病呈现出不同的病理生理和临床过程,且预后更好。