Aghayev Rauf M
Department of Surgical Diseases-II, Azerbaijan Medical University, Baku, Azerbaijan.
Euroasian J Hepatogastroenterol. 2016 Jul-Dec;6(2):125-130. doi: 10.5005/jp-journals-10018-1183. Epub 2016 Dec 1.
A total of 302 patients with liver echinococcosis (LE) complicated by lesions of bile duct during 1988 to 2015 were analyzed. The patients were divided into two groups. In the first group, 227 patients were included with lesions of segmental bile ducts in the form of cystobiliary and bilio-bronchial fistulas. In the second group, 75 patients with lesions of hepatic bile were enrolled. Diagnosis of LE and its complications was made by ultrasonography and computed tomography (CT). Surgical treatment included echinococcectomy with complete liquidation of a residual cavity (35.1%), echinococcectomy with suturing (46.0%), external drainage of a residual cavity (7.3%), pericystectomy (8.6%), and resection of a liver (3.0%). Postoperative complications related to operative intervention developed in 29 patients. Lethal outcomes took place in 6 cases (2.0%). The analysis has shown that the form of bile duct lesions, methods of surgical operation for liquidation of hydatid cysts, and its biliary complications had influenced the treatment outcome. More optimal results are received after complete liquidation of residual cavity in different ways and suturing of cystobiliary fistulas during operation. For prevention of complications related to the presence of residual cavity, laser processing of walls of a residual cavity by ozonized 17% hypertonic solution of NaCl was used and this procedure showed obvious (p < 0.05) advantages.
Aghayev RM. Liver Echinococcosis complicated with Lesions of Bile Ducts in Azerbaijan. Euroasian J Hepato-Gastroenterol 2016;6(2):125-130.
分析了1988年至2015年期间共302例肝包虫病(LE)合并胆管病变的患者。将患者分为两组。第一组纳入227例,其胆管病变表现为胆囊胆管瘘和胆支气管瘘形式的节段性胆管病变。第二组纳入75例肝内胆管病变患者。通过超声检查和计算机断层扫描(CT)对LE及其并发症进行诊断。手术治疗包括彻底清除残留腔的包虫切除术(35.1%)、缝合的包虫切除术(46.0%)、残留腔的外引流术(7.3%)、囊肿切除术(8.6%)和肝切除术(3.0%)。29例患者发生了与手术干预相关的术后并发症。6例患者死亡(2.0%)。分析表明,胆管病变的形式、清除包虫囊肿的手术方法及其胆道并发症对治疗结果有影响。通过不同方式彻底清除残留腔并在手术中缝合胆囊胆管瘘后可获得更优的结果。为预防与残留腔存在相关的并发症,采用17%臭氧化高渗氯化钠溶液对残留腔壁进行激光处理,该方法显示出明显(p<0.05)的优势。
Aghayev RM. 阿塞拜疆肝包虫病合并胆管病变。《欧亚肝脏胃肠病学杂志》2016;6(2):125 - 130。