Mohan Suyash, Garg Shobhit K, Kathuria Manoj, Baijal Sanjay Saran
Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
Trop Gastroenterol. 2011 Jul-Sep;32(3):189-95.
To present our experience with management of complex hepatic hydatid cysts (Gharbi type III), using percutaneous large bore catheter drainage followed by active mechanical suction of cyst contents.
Eleven patients (6 males and 5 females with a mean age of 43.2 years), with 13 complex Gharbi type III hepatic hydatid cysts were included in the study. Under sonography guidance the complex heterogeneous hepatic hydatid cysts were treated percutaneously using large bore drainage catheter and active mechanical suction.
Successful drainage of all 13 complex Gharbi type III hepatic hydatid cysts was achieved in all patients (n = 11). The mean duration of catheter placement was 11.3 days (range 7 to 40 days). The most common problem encountered was biliary fistula (n = 3), which was effectively managed with prolonged catheter drainage and/or endoscopic intervention. No serious complications or deaths were encountered. Minor complications were seen in 7 patients including, urticaria in 3, fever in 2 and reactive pleural effusion in 3. All patients responded to symptomatic treatment. Follow up serial ultrasound was performed on all patients, that showed near complete healing in 9 and formation ofpseudotumour in 4 patients. There was no recurrence with a mean follow up of 15.23 months (6 months - 2 years).
Percutaneous suction and large bore catheter drainage of Gharbi type III hepatic hydatid cysts is a safe and effective alternative therapy.
介绍我们采用经皮大口径导管引流并积极机械抽吸囊肿内容物来处理复杂肝包虫囊肿（加尔比III型）的经验。
本研究纳入了11例患者（6例男性和5例女性，平均年龄43.2岁），共13个复杂的加尔比III型肝包虫囊肿。在超声引导下，使用大口径引流导管对复杂的异质性肝包虫囊肿进行经皮治疗，并积极进行机械抽吸。
所有患者（n = 11）的13个复杂加尔比III型肝包虫囊肿均成功引流。导管放置的平均时间为11.3天（范围7至40天）。最常见的问题是胆瘘（n = 3），通过延长导管引流和/或内镜干预得到有效处理。未出现严重并发症或死亡。7例患者出现轻微并发症，包括3例荨麻疹、2例发热和3例反应性胸腔积液。所有患者经对症治疗后均有反应。对所有患者进行了系列超声随访，9例显示近乎完全愈合，4例形成假瘤。平均随访15.23个月（6个月至2年）无复发。
经皮抽吸和大口径导管引流加尔比III型肝包虫囊肿是一种安全有效的替代治疗方法。
