Röthlin M A
Department of-Surgery, Zürich University Hospital, Switzerland.
Am J Gastroenterol. 1998 Dec;93(12):2606-7. doi: 10.1111/j.1572-0241.1998.00562.x.
A 43-yr-old woman was operated for recurring hydatid cysts of the liver. One of the cysts was located in segment 8 adjacent to both inferior vena cava and right hepatic vein. During the operation, after application of traction on the liver the patient suddenly went into cardiac arrest. After applying open heart massage a Trendelenburg operation was performed, revealing a massive embolus of echinococcal material into the paracentral branches of the pulmonary artery. Resuscitation was unsuccessful. In the literature only four similar cases have been described. The conclusions from these deaths are that an adequate incision is mandatory, no traction on the liver should be necessary, and total vascular exclusion of the liver before cyst drainage and extracorporal bypass are necessary. Interventional techniques should be avoided.
一名43岁女性因复发性肝包虫囊肿接受手术。其中一个囊肿位于第8段，毗邻下腔静脉和右肝静脉。手术过程中，在对肝脏施加牵引后，患者突然心脏骤停。在进行心脏按压后，实施了特伦德伦伯卧位手术，发现大量棘球蚴物质栓塞至肺动脉的中央旁分支。复苏未成功。文献中仅描述了4例类似病例。这些死亡病例得出的结论是，必须有足够的切口，无需对肝脏进行牵引，在囊肿引流前对肝脏进行全血管阻断和体外循环是必要的。应避免采用介入技术。
