Filip V, Niculescu D, Târcoveanu E, Dănilă N, Ene D, Popa Paula, Neacşu C N, Moldovanu R, Crumpei Felicia
Universitatea de Medicină si Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica I Chirurgie.
Rev Med Chir Soc Med Nat Iasi. 2005 Apr-Jun;109(2):294-9.
Hydatid disease of the liver is still endemic in certain parts of the world. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy. Surgery is still the treatment of choice and can be performed by the conventional or laparoscopic approach. The aim of the study is to analyze the results of the surgical treatment in hydatid disease of the liver in First Surgical Clinic, Iaşi. The study concerned a period of 12.5 years (1992 - 31.07.2004) and it included 337 cases. There were performed radical procedures (ideal cystectomy - 17 cases - 5.04%, hepatic segmentectomy - 8 cases - 1.48%, atypical hepatectomy - 10 cases - 2.96%) or conservative procedures (de-roofing - 37 cases - 10.97%, subtotal pericystectomy - 34 cases -10.80%, total pericystectomy - 19 cases - 5.63%, partial pericystectomy - 212 cases -62.90%). In 35 cases (10.38%) the operation was started laparoscopically and 12 cases needed conversion. Postoperative course was complicated in 112 cases (33.32%) (external biliary fistula, cavity suppuration, residual cavity hydatid relapse). Radical methods constituted operations that had excellent results, but they are feasible in few cases. Conservative procedures, relatively simple and still accepted, have a higher rate of morbidity. The laparoscopic approach is more and more used, with good results.
肝包虫病在世界某些地区仍然是地方病。现代治疗肝包虫囊肿的方法从手术干预到经皮引流或药物治疗不等。手术仍然是首选治疗方法，可以通过传统或腹腔镜方法进行。本研究的目的是分析雅西第一外科诊所肝包虫病手术治疗的结果。该研究涉及12.5年（1992年至2004年7月31日），共纳入337例病例。实施了根治性手术（理想囊肿切除术17例，占5.04%；肝段切除术8例，占1.48%；非典型肝切除术10例，占2.96%）或保守性手术（去顶术37例，占10.97%；次全囊肿切除术34例，占10.80%；全囊肿切除术19例，占5.63%；部分囊肿切除术212例，占62.90%）。35例（10.38%）手术开始时采用腹腔镜手术，12例需要转为开腹手术。112例（33.32%）术后病程出现并发症（外胆瘘、腔隙化脓、残余腔隙包虫复发）。根治性方法手术效果极佳，但仅适用于少数病例。保守性手术相对简单且仍被接受，但发病率较高。腹腔镜手术方法的应用越来越广泛，效果良好。
