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根治性手术与保守性手术治疗肝包虫囊肿:单中心经验。

Radical vs conservative surgery for hydatid liver cysts: experience from single center.

机构信息

Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Diyarbakir, Turkey.

出版信息

World J Gastroenterol. 2010 Feb 28;16(8):953-9. doi: 10.3748/wjg.v16.i8.953.

Abstract

AIM

To compare the efficacy and safety of radical and conservative surgical interventions for liver hydatid disease.

METHODS

The study comprised 59 patients in two groups who had undergone radical and conservative surgical procedures for liver hydatid disease in our department between 2004 and 2009. Preoperative diagnostic tools, medical treatments, demographic and clinical characteristics, postoperative follow-up, and recurrence were compared in both groups.

RESULTS

This non-randomized retrospective study included 59 patients who had undergone liver hydatid disease surgery. The radical technique was used in 18 patients (mean age: 42.1 +/- 13.5 years, seven male, 11 female), and the conservative technique was used in 41 patients (mean age: 43.5 +/- 13.9 years, 17 male, 24 female). The follow-up period ranged from 3 to 58 mo. Although operative time was significantly shorter in the conservative group (P < 0.001), recurrence was significantly reduced in the radical group (P = 0.045). No statistically significant differences were found in terms of hospitalization duration, cyst count and size, location, postoperative complications, scolicidal solution usage, or follow-up duration between the two groups.

CONCLUSION

The more effective method for preventing postoperative recurrence is radical surgery. Endoscopic retrograde cholangiopancreatography for bile leakage in the early postoperative period may decrease the requirement for repeat surgery.

摘要

目的

比较根治性和保守性手术干预肝包虫病的疗效和安全性。

方法

本研究纳入了 2004 年至 2009 年期间在我科接受根治性和保守性手术治疗的肝包虫病患者 59 例,分为两组。比较两组患者的术前诊断工具、药物治疗、人口统计学和临床特征、术后随访和复发情况。

结果

本非随机回顾性研究纳入了 59 例接受肝包虫病手术的患者。根治性手术组 18 例(平均年龄:42.1 ± 13.5 岁,男 7 例,女 11 例),保守性手术组 41 例(平均年龄:43.5 ± 13.9 岁,男 17 例,女 24 例)。随访时间 3 至 58 个月。虽然保守性手术组的手术时间明显更短(P < 0.001),但根治性手术组的复发率明显降低(P = 0.045)。两组在住院时间、囊肿数量和大小、位置、术后并发症、杀囊液使用和随访时间方面无统计学差异。

结论

预防术后复发的更有效方法是根治性手术。对于术后早期的胆漏,经内镜逆行胰胆管造影术可能减少再次手术的需求。

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