MDT discussion of radical hepatectomy of complex vesicular Hepatocystis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Kefei ¹ , TANG Youyin ¹ , JIA Guiqing ¹ , FANG Dan ¹ , Singh Roshankumar ¹ ,  CHEN Zheyu ¹ , WU Bing ² , LIU Kai ³ , ZHOU Taoyou ³ , LU Qiang ⁴

1. Department of Hepatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Radiological department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Infectious Disease Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Ultrasonography Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHEN Zheyu, Email: chenzheyu71@163.com

Keywords：

complex alveolar hydatid echinococcosis; radical hepatectomy; multidisciplinary team

DOI：

10.7507/1007-9424.201712087

Video：

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Objective To improve the effect of surgical treatment for complex alveolar hydatid echinococcosis through multidisciplinary team (MDT) discussion. Methods The clinical data of 1 case of complicated alveolar echinococcosis treated in West China Hospital were discussed by MDT, and the best operation scheme was selected and followed-up for the patients. Results The CT imaging of the patient suggested the infringement of the first and second hepatic portal and inferior vena cava, decided to discuss the radical right hepatectomy and three biliary intestinal anastomosis by MDT, postoperative application of albendazole, was discharged after 12 months follow-up showed no recurrence of hepatic echinococcosis, and left liver obvious regeneration. Conclusion Complicated alveolar echinoccosis excision rate is low by surgical methods, through the discussion of MDT multidisciplinary can increase the efficacy of surgical treatment.

Citation： CHEN Kefei, TANG Youyin, JIA Guiqing, FANG Dan, Singh Roshankumar, CHEN Zheyu, WU Bing, LIU Kai, ZHOU Taoyou, LU Qiang. MDT discussion of radical hepatectomy of complex vesicular Hepatocystis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(1): 77-82. doi: 10.7507/1007-9424.201712087 Copy

1.	李海涛, 吐尔干·艾力, 阿依甫汗, 等. 手术联合药物治疗多器官泡型包虫病临床观察. 中华医学杂志, 2010, 90(40): 2839-2842.
2.	Geramizadeh B, Nikeghbalian S, Malekhosseini SA. Alveolar echinococcosis of the liver. Hepat Mon, 2012, 12(9): e6143- e6147.
3.	陈哲宇. 复杂肝包虫病的外科治疗. 中国普外基础与临床杂志, 2017, 24(7): 785-787.
4.	陈哲宇. 肝包虫病的治疗方法选择. 中华临床医师杂志: 电子版, 2015, 9(18): 3329-3331.
5.	McManus DP, Zhang W, Li J, et al. Echinococcosis. Lancet, 2003, 362(9392): 1295-1304.
6.	Torgerson PR, Schweiger A, Deplazes P, et al. Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years. J Hepatol, 2008, 49(1): 72-77.
7.	Varadarajulu S, Christein JD, Tamhane A, et al. Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos). Gastrointest Endosc, 2008, 68(6): 1102-1111.
8.	Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop, 2010, 114(1): 1-16.
9.	Buttenschoen K, Gruener B, Carli Buttenschoen D, et al. Palliative operation for the treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(1): 199-204.
10.	Kasai Y, Koshino I, Kawanishi N, et al. Alveolar echinococcosis of the liver,studies on 60 operated cases. Ann Surg, 1980, 191(2): 145-152.
11.	Partenskey C, Landraud R, Valett PJ, et al. Radical and nonradical hepatic resection for alveolar echinococcosis: report of 18 cases. Word J Surg, 1900, 14(5): 654-659.
12.	温浩. 两型肝包虫病手术疗效547例临床分析. 中华消化外科杂志, 2007, 6(1): 13-18.
13.	阿依甫汗·阿汗, 吐尔干艾力, 邵英梅, 等. 肝包虫的外科治疗现状. 肝胆外科杂志, 2009, 17(1): 13-14.
14.	Du CZ, Li J, Cai Y, et al. Effect of multidisciplinary team treatment on outcomes of patients with gastrointestinal malignancy. World J Gestroenterol, 2011, 17(15): 2013-2018.
15.	Friedland PL, Bozic B, Dewar J, et al. Impact of multidisciplinary team management in head and neck cancer patients. British J Cancer, 2011, 104(8): 1246-1248.
16.	刘金刚. 肥胖者与 2 型糖尿病外科治疗的规范和推广. 中华消化外科杂志, 2013, 12(12): 897-900.
17.	Hshieh TT, Sundaram V. Liver transplantation for hepatocellular carcinoma: are international guidelines possible? Hepatobiliary Surg Nutr, 2013, 2(2): 113-116.
18.	陈哲宇. 泡型肝包虫病的外科治疗现状. 中国普外基础与临床杂志, 2016, 23(5): 513-516.
19.	Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol, 2012, 18(13): 1448-1558.
20.	Starzl TE. The long reach of liver transplantation. Exp Clin Transplant, 2013, 11(2): 87-92.
21.	Koch S, Bresson-Hadni S, Miguet JP, et al. Experience of liver transplantation for incurable alveolar echinococcosis: a 45-case European collaborative report. Transplantation, 2003, 75(6): 856-863.
22.	Bresson-Hadni S, Blagosklonov O, Knapp J, et al. Should possible recurrence of disease contraindicate liver transplantation in patients with end-stage alveolar echinococcosis? A 20-year follow-up study. Liver Transpl, 2011, 17(7): 855-865.
23.	Chauchet A, Grenouillet F, Knapp J, et al. Increased incidence and characteristics of alveolar echinococcosis in patients with immunosuppression-associated conditions. Clin Infect Dis, 2014, 59(8): 1095-1104.
24.	Lei JY, Hao JC, Wang WT, et al. Ex vivo liver resection followed by autotransplantation to a patient with advanced alveolar echinococcosis with a replacement of the retrohepatic inferior vena cava using autogenous vein grafting: a case report and literature review. Medicine (Baltimore), 2015, 94(7): e514.

1. 李海涛, 吐尔干·艾力, 阿依甫汗, 等. 手术联合药物治疗多器官泡型包虫病临床观察. 中华医学杂志, 2010, 90(40): 2839-2842.
2. Geramizadeh B, Nikeghbalian S, Malekhosseini SA. Alveolar echinococcosis of the liver. Hepat Mon, 2012, 12(9): e6143- e6147.
3. 陈哲宇. 复杂肝包虫病的外科治疗. 中国普外基础与临床杂志, 2017, 24(7): 785-787.
4. 陈哲宇. 肝包虫病的治疗方法选择. 中华临床医师杂志: 电子版, 2015, 9(18): 3329-3331.
5. McManus DP, Zhang W, Li J, et al. Echinococcosis. Lancet, 2003, 362(9392): 1295-1304.
6. Torgerson PR, Schweiger A, Deplazes P, et al. Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years. J Hepatol, 2008, 49(1): 72-77.
7. Varadarajulu S, Christein JD, Tamhane A, et al. Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos). Gastrointest Endosc, 2008, 68(6): 1102-1111.
8. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop, 2010, 114(1): 1-16.
9. Buttenschoen K, Gruener B, Carli Buttenschoen D, et al. Palliative operation for the treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(1): 199-204.
10. Kasai Y, Koshino I, Kawanishi N, et al. Alveolar echinococcosis of the liver,studies on 60 operated cases. Ann Surg, 1980, 191(2): 145-152.
11. Partenskey C, Landraud R, Valett PJ, et al. Radical and nonradical hepatic resection for alveolar echinococcosis: report of 18 cases. Word J Surg, 1900, 14(5): 654-659.
12. 温浩. 两型肝包虫病手术疗效547例临床分析. 中华消化外科杂志, 2007, 6(1): 13-18.
13. 阿依甫汗·阿汗, 吐尔干艾力, 邵英梅, 等. 肝包虫的外科治疗现状. 肝胆外科杂志, 2009, 17(1): 13-14.
14. Du CZ, Li J, Cai Y, et al. Effect of multidisciplinary team treatment on outcomes of patients with gastrointestinal malignancy. World J Gestroenterol, 2011, 17(15): 2013-2018.
15. Friedland PL, Bozic B, Dewar J, et al. Impact of multidisciplinary team management in head and neck cancer patients. British J Cancer, 2011, 104(8): 1246-1248.
16. 刘金刚. 肥胖者与 2 型糖尿病外科治疗的规范和推广. 中华消化外科杂志, 2013, 12(12): 897-900.
17. Hshieh TT, Sundaram V. Liver transplantation for hepatocellular carcinoma: are international guidelines possible? Hepatobiliary Surg Nutr, 2013, 2(2): 113-116.
18. 陈哲宇. 泡型肝包虫病的外科治疗现状. 中国普外基础与临床杂志, 2016, 23(5): 513-516.
19. Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol, 2012, 18(13): 1448-1558.
20. Starzl TE. The long reach of liver transplantation. Exp Clin Transplant, 2013, 11(2): 87-92.
21. Koch S, Bresson-Hadni S, Miguet JP, et al. Experience of liver transplantation for incurable alveolar echinococcosis: a 45-case European collaborative report. Transplantation, 2003, 75(6): 856-863.
22. Bresson-Hadni S, Blagosklonov O, Knapp J, et al. Should possible recurrence of disease contraindicate liver transplantation in patients with end-stage alveolar echinococcosis? A 20-year follow-up study. Liver Transpl, 2011, 17(7): 855-865.
23. Chauchet A, Grenouillet F, Knapp J, et al. Increased incidence and characteristics of alveolar echinococcosis in patients with immunosuppression-associated conditions. Clin Infect Dis, 2014, 59(8): 1095-1104.
24. Lei JY, Hao JC, Wang WT, et al. Ex vivo liver resection followed by autotransplantation to a patient with advanced alveolar echinococcosis with a replacement of the retrohepatic inferior vena cava using autogenous vein grafting: a case report and literature review. Medicine (Baltimore), 2015, 94(7): e514.

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MDT discussion of radical hepatectomy of complex vesicular Hepatocystis

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