Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow 226010, India.
Trans R Soc Trop Med Hyg. 2014 May;108(5):264-8. doi: 10.1093/trstmh/tru003. Epub 2014 Jan 30.
Hydatid disease, infection with the larval stage of the cestode Echinococcus spp., represents a substantial disease burden worldwide. We report here the outcomes of conservative surgery in patients with abdominal echinococcosis.
We carried out a retrospective review of patients who underwent conservative surgery for abdominal hydatid disease during the period January 2008 to December 2011. Perioperative outcomes were analysed after a mean follow-up of 24 months (range 6-36 months).
Thirty patients (mean age 40.4 years; male:female=7:3) underwent surgery. Most (29 patients) had a hepatic hydatid cyst and underwent partial cystectomy with omentoplasty; surgery was open in 22 cases (73%), laparoscopic in six cases (20%) and laparoscopic converted to open in one case (3%); one patient with a splenic cyst underwent open splenectomy. Cystobiliary communication was present in 10 cases (3%). Postoperative complications included transient biliary leak in two cases (7%), grade 1 surgical site infection in five cases (17%) and respiratory tract infection in three cases (10%), with no mortality. Mean hospital stay was 17 ± 9.2 days. None of the patients had recurrence of disease on follow-up imaging.
Conservative surgery offers an effective approach for abdominal echinococcosis, with minimal morbidity or recurrence, and is an alternative to radical procedures.
包虫病，由绦虫属幼虫引起的感染，在全球范围内造成了相当大的疾病负担。我们在此报告接受保守手术治疗的腹部包虫病患者的结局。
我们回顾性分析了 2008 年 1 月至 2011 年 12 月期间接受腹部包虫病保守手术治疗的患者。平均随访 24 个月（6-36 个月）后分析围手术期结局。
30 例患者（平均年龄 40.4 岁；男：女=7:3）接受了手术。大多数患者（29 例）患有肝包虫囊肿，行部分囊肿切除术联合大网膜包裹术；22 例（73%）采用开放性手术，6 例（20%）采用腹腔镜手术，1 例（3%）由腹腔镜转为开放性手术；1 例脾囊肿患者行开放性脾切除术。10 例（3%）存在囊胆沟通。术后并发症包括 2 例（7%）短暂性胆漏，5 例（17%）1 级手术部位感染和 3 例（10%）呼吸道感染，无死亡病例。平均住院时间为 17±9.2 天。所有患者在随访影像学检查中均未发现疾病复发。
保守手术为腹部包虫病提供了一种有效的治疗方法，其发病率或复发率低，是根治性手术的替代方法。
