Lerut J, Kartheuser A, Gianello P, Otte J B, Kestens P J
Acta Chir Belg. 1986 Jul-Aug;86(4):208-15.
The authors present a series of 33 cases of hydatid liver disease; 28 patients are operated upon. Ultrasound and parasitology permits an easy diagnosis. Surgical treatment has to be simple: resection of the cyst dome and subtotal pericystectomy guarantee low mortality and recurrence rate. The hospital mortality of this series is 7% (2/28 pat.); the cyst recurrence rate 2.7% (1/37 treated cysts). Surgery of the hydatid cyst necessitates a complete peroperative exploration of the bile duct and the residual cyst cavity by peroperative cholangiography and injection of methylene blue. Biliary fistulas have to be treated in accordance to their importance, by simple suture or intubation with transhepatic drainage. An adequate follow-up is only possible by repeated serological examinations.
作者报告了33例肝包虫病病例;其中28例患者接受了手术治疗。超声检查和寄生虫学检查有助于轻松做出诊断。手术治疗必须简单:囊肿顶部切除和囊肿次全切除术可确保低死亡率和复发率。该系列的医院死亡率为7%(2/28例);囊肿复发率为2.7%(1/37个接受治疗的囊肿)。肝包虫囊肿手术需要通过术中胆管造影和注射亚甲蓝对胆管和残留囊肿腔进行全面的术中探查。胆管瘘必须根据其严重程度进行治疗,可采用简单缝合或经肝引流插管。只有通过反复的血清学检查才能进行充分的随访。