Mihăilă Daniela E, Nitu M C, Potecă T D
Rom J Intern Med. 2016 Jan-Mar;54(1):47-53. doi: 10.1515/rjim-2016-0005.
Hydatidosis is a parasitic disease with tumour-like development of a cystic mass. This has specific endemic areas, Romania being amongst them. Our hospital has national addressability and the collaboration between the Departments of Parasitology, General Surgery and Pathology ensures optimal multidisciplinary approach to cases of therapeutic and diagnostic standpoint. The study aims to test the hypothesis that the gallbladder is a hydatid reservoir, to identify signs of biliary fistulas in the pericyst and liver parenchyma; to identify inflammation elements in the pericyst and the gallbladder.
The study is a retrospective observational one, carried out between 2011-2014, on a total of 35 patients operated for hepatic hydatidosis in the General Surgery Department of "Colentina" Clinical Hospital. All the selected patients had sent to the Pathology Department: gallbladder, cyst and pericyst. Statistical analysis of the data was performed using SPSS package Statistics 19.
The main results of the study revealed no evidence to confirm the hypothesis that the gallbladder is a hydatid reservoir. Out of the 35 cases, in 16 we observed the tendency to include hepatic biliary ducts in the pericyst or the formation of new canals which lead to the formation of biliary fistulas. Using immunohistochemical techniques with mark of CK19 (cytokeratin 19), have been observed the pattern of fistulization and modification of local architecture through the formation of the pericyst, in 16/35 (45.7%) of cases.
Although it is a benign pathology, the evolution of hepatic hydatidosis can lead to severe complications and a low quality of life for the patient, both before and after surgery. Better knowledge of the pathology behind the local evolution of the disease can influence the therapeutic approach.
包虫病是一种寄生虫病,其特征为出现肿瘤样的囊性肿块。该病有特定的流行地区,罗马尼亚是其中之一。我院具备全国性的诊疗能力,寄生虫学、普通外科和病理学部门之间的合作确保了从治疗和诊断角度对病例采取最佳的多学科方法。本研究旨在验证胆囊是包虫储库这一假说,识别包囊周围和肝实质内胆瘘的迹象;识别包囊周围和胆囊内的炎症成分。
本研究为回顾性观察研究,于2011年至2014年期间,对“科伦蒂纳”临床医院普通外科35例接受肝包虫病手术的患者进行。所有选定患者的胆囊、囊肿和包囊均送至病理科。使用SPSS统计软件包19对数据进行统计分析。
该研究的主要结果显示,没有证据证实胆囊是包虫储库这一假说。在35例病例中,有16例我们观察到肝内胆管有纳入包囊周围或形成新管道从而导致胆瘘形成的趋势。通过使用细胞角蛋白19(CK19)标记的免疫组织化学技术,在16/35(45.7%)的病例中观察到了包囊周围形成导致瘘管形成和局部结构改变的模式。
尽管肝包虫病是一种良性病变,但无论在手术前后,其病情发展都可能导致严重并发症并降低患者生活质量。更好地了解该疾病局部发展背后的病理情况可影响治疗方法。