Röthlin M, Decurtins M, Largiadèr F
Klinik für Viszeralchirurgie, Departement Chirurgie, Universitätsspital Zürich.
Helv Chir Acta. 1994 Apr;60(4):587-92.
Echinococcosis of the liver is a disease rarely seen in Switzerland. E. alveolaris is the parasite causing the indigenous cases, while most of the patients infected by E. cysticus have migrated from the Mediterranean region. 26 patients suffering from echinococcosis of the liver were treated at the Department of Surgery of Zürich University Hospital between 1983 and 1992. There were 12 female and 14 male patients aged between 21 and 72 years (mean: 41 yrs). In 6 cases the cause was an infection with E. alveolaris (group 1), all the other patients suffered from E. cysticus infection (group 2). In group 1, there were 3 segmentectomies, 2 hemihepatectomies and 1 exploratory laparotomy. In group 2, 16 patients underwent pericystectomy. Furthermore, 1 hemihepatectomy, 3 atypical resections and 2 segmentectomies were performed. Complications were seen in 100% in group 1 and in in 35% in group 2, respectively. 2 patients died postoperatively for a mortality of 8%. We concluded that infections with E. alveolaris are rarely resectable without increasing drastically the risk of the operation. Therefore, postoperative long-term chemotherapy is necessary. Operations for both types of echinococcosis are fraught with a high rate of complications.
肝包虫病在瑞士较为罕见。多房棘球绦虫是导致本地病例的寄生虫，而大多数感染细粒棘球绦虫的患者是从地中海地区移民而来。1983年至1992年间，苏黎世大学医院外科收治了26例肝包虫病患者。其中女性12例，男性14例，年龄在21岁至72岁之间（平均41岁）。6例病因是多房棘球绦虫感染（第1组），其他所有患者均为细粒棘球绦虫感染（第2组）。第1组中，3例行节段切除术，2例行半肝切除术，1例行剖腹探查术。第2组中，16例患者接受了囊肿切除术。此外，还进行了1例半肝切除术、3例非典型切除术和2例节段切除术。第1组和第2组的并发症发生率分别为100%和35%。2例患者术后死亡，死亡率为8%。我们得出结论，多房棘球绦虫感染在不显著增加手术风险的情况下很少可切除。因此，术后长期化疗是必要的。两种类型的包虫病手术都充满了高并发症发生率。
