手术治疗钙化型肝细粒棘球蚴病的效果观察

高宇; 吴向未; 刘桂生; 雷振

doi:10.3969/j.issn.1001-5256.2020.03.029

手术治疗钙化型肝细粒棘球蚴病的效果观察

DOI: 10.3969/j.issn.1001-5256.2020.03.029

石河子大学医学院第一附属医院肝胆外科

基金项目:

国家自然科学基金项目(81760570)；

详细信息

中图分类号: R657.3
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出版历程
- 收稿日期: 2019-10-23
- 出版日期: 2020-03-20

Clinical effect of surgery in treatment of calcified hepatic cystic echinococcosis

Department of Hepatobiliary Surgery,The First Affiliated Hospital of Shihezi University School of Medicine

Research funding:

摘要

摘要: 目的探讨手术治疗钙化型肝细粒棘球蚴病的临床效果。方法回顾性分析2015年11月-2019年2月于石河子大学医学院第一附属医院行手术治疗（外囊完整剥除术、外囊次全切除术及内囊摘除术）的16例共20个钙化型肝细粒棘球蚴囊肿的临床特点及治疗效果。结果 1例患者行外囊完整剥除术,5例患者行内囊摘除术,10例患者行外囊次全切除术。除1例患者因术前囊肿已破入胆道且外囊壁已存在胆瘘而于术后发生胆漏之外,其余患者术后均未发现残腔积液、感染等残腔并发症及胆漏、黄疸。术后均无死亡、复发病例。结论对于非静止期的钙化型肝细粒棘球蚴病必须手术治疗,外囊完整剥除术并不适用,可优先选用外囊次全切除术,尤其是当出现钙化型肝细粒棘球蚴囊肿邻近肝门部、邻近肝内外大血管及外膜与外囊之间的潜在性腔隙不明显时。而当出现肝细粒棘球蚴囊肿破裂时,可酌情选择内囊摘除术。
- 棘球蚴病,肝 /
- 消化系统外科手术 /
- 治疗结果
Abstract: Objective To investigate the clinical effect of surgery in the treatment of calcified hepatic cystic echinococcosis. Methods A retrospective analysis was performed for the clinical data of 16 patients with 20 calcified hepatic hydatid cysts who underwent surgical treatment( total pericystectomy,subtotal pericystectomy,and endocystectomy) in The First Affiliated Hospital of Shihezi University School of Medicine from November 2015 to February 2019. Results Of all 16 patients,1 underwent total pericystectomy,5 underwent endocystectomy,and 10 underwent subtotal pericystectomy. One patient experienced bile leakage after surgery since the cyst ruptured and entered the bile duct and there was a biliary fistula in the outer wall of the cyst before surgery,and the other patients had no residual cavity complications including residual cavity effusion and infection,bile leakage,or jaundice. There was no death and recurrence after operation. Conclusion Surgical treatment is necessary for non-stationary calcified hepatic cystic echinococcosis. Total pericystectomy is not suitable,while subtotal pericystectomy may be the preferred surgical method,especially when the calcified hepatic hydatid cyst is located near the porta hepatis or the intrahepatic and extrahepatic vessels and there is no obvious lacunae between the adventitia and the outer cyst. Endocystectomy can be selected when hepatic hydatid cyst ruptures.
- echinococcosis,hepatic /
- digestive system surgical procedures /
- treatment outcome

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