肝包虫囊肿的急诊/择期手术和急诊经皮介入治疗及其结果。
Emergency/Elective Surgery and Emergency Percutaneous Interventions in Liver Hydatid Cysts and Their Results.
机构信息
Department of Gastroenterological Surgery, Manisa City Hospital, Manisa, Turkey.
Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey.
出版信息
Turk J Gastroenterol. 2023 Oct;34(10):1071-1077. doi: 10.5152/tjg.2023.22818.
BACKGROUND
Hydatid cyst may remain asymptomatic for several years or may become complicated. The aim of this study is to evaluate the patients who were operated on for liver hydatid cyst in our clinic and the results of preoperative or postoperative complications.
METHODS
The data of 836 patients who underwent surgery (n = 750) or Puncture, Aspiration, Injection, and Re-aspiration (n = 86) for hydatid cyst disease in our clinic between January 2006 and January 2021 were evaluated retrospectively.
RESULTS
Surgical operation was performed in 750 of the patients and Puncture, Aspiration, Injection, and Re-aspiration procedure was performed in 89 of the patients. In the surgery and Puncture, Aspiration, Injection, and Re-aspiration group, respiratory distress, anaphylaxis, allergic rash, and urticaria were observed in 11 patients (8 in Puncture, Aspiration, Injection, and Re-aspiration group and 3 in open surgery group). All patients recovered with emergency medical interventions. Recurrence was observed after the percutaneous procedure in 11 cases and after surgery in 36 cases. There was no statistically significant difference between the surgical and Puncture, Aspiration, Injection, and Re-aspiration groups in terms of recurrence and cyst infection (P = .253 and P = .547, respectively). The incidence of the development of intrabiliary rupture, allergic reaction, and intraperitoneal rupture was found 135 (16.14%), 12 (1.43%), and 2 (0.23%) in our study, respectively.
CONCLUSIONS
Intraperitoneal or intrabiliary rupture is a rare but fatal complication of hydatid cyst. The presence of fever, jaundice, abdominal pain, urticaria, and anaphylactic reactions in endemic areas should take the suspicion of hydatid cyst rupture. The timing of surgery is an important factor affecting morbidity and mortality. Detailed exploration of the abdomen in emergency surgery for rupture hydatid cyst is essential for recurrence.
背景
包虫囊肿可能在数年无症状，也可能变得复杂。本研究旨在评估在我院接受肝包虫囊肿手术治疗的患者及术前或术后并发症的结果。
方法
回顾性分析 2006 年 1 月至 2021 年 1 月期间我院因包虫病行手术（n=750）或穿刺抽吸注射术（n=86）的 836 例患者的临床资料。
结果
750 例患者接受手术治疗，89 例患者行穿刺抽吸注射术。手术组和穿刺抽吸注射术组中，分别有 11 例（穿刺抽吸注射术组 8 例，开放性手术组 3 例）患者出现呼吸困难、过敏反应、过敏性皮疹和荨麻疹。所有患者均通过急诊治疗恢复。经皮治疗后 11 例复发，手术治疗后 36 例复发。手术组和穿刺抽吸注射术组的复发率和囊肿感染率差异无统计学意义（P=0.253 和 P=0.547）。本研究中，胆管内破裂、过敏反应和腹腔内破裂的发生率分别为 135 例（16.14%）、12 例（1.43%）和 2 例（0.23%）。
结论
肝包虫囊肿破裂是一种罕见但致命的并发症。在流行地区，发热、黄疸、腹痛、荨麻疹和过敏反应的出现应怀疑包虫囊肿破裂。手术时机是影响发病率和死亡率的重要因素。对于破裂的包虫囊肿，急诊手术详细探查对复发至关重要。
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