Shen Hao-De, Chen Ke-Fei, Li Bo, Zhang Han-Zhi, Yang Kang-Ming, Chen Yin, Li Jia-Xin, Chen Zhe-Yu, Meng Ta, Ma Zhi, Li Hong-Zhi
Department of Liver Surgery and Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu Hydatid Disease Institute of Ganzi Prefecture, Ganzi Tibetan Autonomous Prefecture, Sichuan Province, China.
Medicine (Baltimore). 2017 Aug;96(33):e7819. doi: 10.1097/MD.0000000000007819.
Alveolar echinococcosis is a chronically progressive and potentially fatal disease. Patients with multiple giant alveolar echinococcosis have a poor prognosis when radical resection cannot be achieved, but curative resection can be limited by low future remnant liver volumes. In these cases, 2-stage liver resection may be a better choice: after a first-stage hepatectomy with partial resection, liver regeneration is allowed in the residual liver before proceeding to the second-stage hepatectomy. In this study, we therefore retrospectively reviewed and evaluated the safety and feasibility of two-stage hepatectomy in patients with multiple giant alveolar echinococcosis.We reviewed the data for all patients who underwent 2-stage hepatectomy for multiple giant alveolar echinococcosis between August 2013 and December 2015 at either the West China Hospital of Sichuan University or the Hospital of Ganzi Tibetan Autonomous Prefecture.We identified 7 patients in whom 2-stage hepatectomy was completed. During the first-stage hepatectomy, 4 patients underwent right-sided hepatectomy and the other 3 underwent left-sided hepatectomy. The second-stage hepatectomies were successfully performed 3 months after the first-stage procedures. All patients had follow-up durations of >1 year; there were no cases of operation-related mortality, and no patients experienced disease recurrence.Two-stage hepatectomy is safe and feasible for patients with multiple giant alveolar echinococcosis.
肺泡型肝包虫病是一种慢性进行性且可能致命的疾病。对于无法实现根治性切除的多灶性巨大肺泡型肝包虫病患者，预后较差，但根治性切除可能会受到未来剩余肝体积过小的限制。在这些情况下，二期肝切除术可能是更好的选择：在进行一期肝部分切除术后，允许残余肝脏进行肝再生，然后再进行二期肝切除术。因此，在本研究中，我们回顾性分析并评估了多灶性巨大肺泡型肝包虫病患者二期肝切除术的安全性和可行性。我们回顾了2013年8月至2015年12月期间在四川大学华西医院或甘孜藏族自治州人民医院接受多灶性巨大肺泡型肝包虫病二期肝切除术的所有患者的数据。我们确定了7例完成二期肝切除术的患者。在一期肝切除术中，4例患者接受了右半肝切除术，另外3例接受了左半肝切除术。二期肝切除术在一期手术3个月后成功进行。所有患者的随访时间均超过1年；无手术相关死亡病例，也无患者出现疾病复发。二期肝切除术对于多灶性巨大肺泡型肝包虫病患者是安全可行的。
