Busić Zeljko, Kolovrat Marijan, Ðuzel Antonija, Rakić Mislav, Cavka Mislav, Begović Amela, Kopljar Mario, Patrlj Leonardo
Lijec Vjesn. 2015 Nov-Dec;137(11-12):361-3.
Echinococcal cyst of the spleen is usually a result of infection with the parasite Echinococcus granulosus. The spleen is the third most frequent localization of echinococcus after liver and lungs. Partial laparoscopic pericystectomy can be done without the loss of blood and scattering of scolexes with spleen preservation and conservation of its immune function. We present the patient with a large (1 8 x 16 x 12 cm) echinococcal cyst of the spleen that compressed the surrounding organs (stomach, transverse colon, pancreas and left kidney), and prevented normal passage causing vomiting after every meal. In this patient, PAIR procedure (puncture, aspiration, injection, reaspiration) and conservative treatment was attempted on several occasions without success. Finally, laparoscopic partial pericystectomy was performed, evacuating the contents of the cyst. The surgery lasted 120 minutes. Postoperatively the patient was without complications. Hospitalization lasted five days. Six months later, the patient is without problems. These echinococcus cysts of the spleen cannot be solved using PAIR technique and conservative treatment. Laparoscopic partial pericystectomy is a better solution than open surgery due to less trauma to the patient, especially in elderly people.
脾脏包虫囊肿通常是由细粒棘球绦虫感染所致。脾脏是继肝脏和肺脏之后包虫最常寄生的第三个部位。部分腹腔镜下囊肿外膜切除术可在不出血且不散落头节的情况下进行,既能保留脾脏,又能保留其免疫功能。我们报告了一例患有巨大(18×16×12厘米)脾脏包虫囊肿的患者,该囊肿压迫周围器官(胃、横结肠、胰腺和左肾),导致每餐饭后出现呕吐,影响正常进食。对该患者多次尝试穿刺、抽吸、注射、再抽吸(PAIR) procedure及保守治疗均未成功。最后,实施了腹腔镜下部分囊肿外膜切除术,排空了囊肿内容物。手术持续了120分钟。术后患者未出现并发症。住院时间为五天。六个月后,患者情况良好。脾脏包虫囊肿无法通过PAIR技术和保守治疗解决。腹腔镜下部分囊肿外膜切除术对患者的创伤较小,比开放手术更好,尤其适用于老年人。