Alan Bircan, Kapan Murat, Teke Memik, Hattapoğlu Salih, Arıkanoğlu Zülfü
Department of Radiology, Dicle University, Diyarbakır, Turkey.
Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
Ther Clin Risk Manag. 2016 Jun 15;12:995-1001. doi: 10.2147/TCRM.S104400. eCollection 2016.
The objectives of this study were to investigate the relationship between the segmental localization of liver hydatid cyst by computed tomography (CT) and the presence of cystobiliary communication (CBC) and to identify the risk factors for CBC.
One hundred and eleven of 163 patients who underwent liver hydatid surgery between January 2011 and September 2014 were included in this study and analyzed retrospectively. The size, number, stage, and segmental and lobar localization of the cysts were investigated by CT. The presence of CBC and preoperative laboratory findings were recorded from operation notes.
CBC was more frequent in single large cysts. CBC was most commonly detected in segment 1 (50%), 8 (48.3%), 7 (41.2%), and 4 (40%). CBC was more frequent in the right lobe (40.4%) and Gharbi stage 3 (41.8%) and 4 (55.6%) lesions. There were no differences in CBC according to distance from the hilus. In addition, preoperative total bilirubin, direct bilirubin, alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) elevations were associated with higher CBC frequency (P<0.05). Cyst diameter, number of cysts, and ALP and GGT elevations were independent predictors of CBC presence.
The evaluation of hydatid cyst diameter, morphological stage, and segmental and lobar localization by abdominal CT and measurement of preoperative cyst diameter, number of cysts, and ALP and GGT values may predict the presence of CBC.
本研究的目的是通过计算机断层扫描（CT）研究肝包虫囊肿的节段定位与囊肿胆管瘘（CBC）的存在之间的关系，并确定CBC的危险因素。
本研究纳入了2011年1月至2014年9月期间接受肝包虫手术的163例患者中的111例，并进行回顾性分析。通过CT研究囊肿的大小、数量、分期以及节段和叶定位。从手术记录中记录CBC的存在情况和术前实验室检查结果。
CBC在单个大囊肿中更常见。CBC最常见于第1段（50%）、第8段（48.3%）、第7段（41.2%）和第4段（40%）。CBC在右叶（40.4%）以及加尔比3期（41.8%）和4期（55.6%）病变中更常见。根据与肝门的距离，CBC没有差异。此外，术前总胆红素、直接胆红素、碱性磷酸酶（ALP）和γ-谷氨酰转移酶（GGT）升高与较高的CBC发生率相关（P<）。囊肿直径、囊肿数量以及ALP和GGT升高是CBC存在的独立预测因素。
通过腹部CT评估包虫囊肿直径、形态分期以及节段和叶定位，以及测量术前囊肿直径、囊肿数量以及ALP和GGT值，可能预测CBC的存在。
