Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York.
Curr Opin Infect Dis. 2023 Oct 1;36(5):348-352. doi: 10.1097/QCO.0000000000000955. Epub 2023 Aug 4.
Cystic echinococcosis is a zoonotic infection frequently involving the liver. Treatment options, including surgery, are decided based on the staging of the disease.
Ultrasound is the cornerstone for diagnosis, staging, and follow-up of cystic echinococcosis. MRI can help to evaluate for cystobiliary complications and planning of the surgery. The two main surgical approaches for cystic echinococcosis include a radical approach, which entails a partial hepatectomy and total pericystectomy, and a conservative approach or endocystectomy. Recent data suggest a conservative approach is well tolerated with acceptable morbidity and no mortality. Recurrences in centers with experience are rare. Data on laparoscopic surgery is emerging, but long-term follow-up still needs to be improved.
Surgical treatment options should be carefully evaluated according to the cystic echinococcosis disease staging. A multidisciplinary approach, including diagnostic and interventional radiology, abdominal and liver surgery, and infectious diseases, results in better outcomes.
肝包虫病是一种常见的人畜共患感染病。治疗方案包括手术，具体取决于疾病的分期。
超声是诊断、分期和随访肝包虫病的基石。磁共振成像（MRI）有助于评估囊胆并发症和手术规划。肝包虫病的两种主要手术方法包括根治性方法，即部分肝切除术和全囊切除术，以及保守性方法或内囊切除术。最近的数据表明，保守性方法具有可接受的发病率和零死亡率，患者耐受性良好。在有经验的中心，复发率较低。腹腔镜手术的数据正在出现，但长期随访仍需改善。
应根据肝包虫病的分期仔细评估手术治疗方案。多学科方法，包括诊断和介入放射学、腹部和肝脏手术以及传染病学，可获得更好的结果。
