Analysis on efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

MA Zhi ^1,2 , WEI Gengfu ^1,2 , SHI Yiyang ^1,2 ,  CHEN Zheyu ^2,3

1. Department of Hepatobiliary Surgery, Hydatid Treatment Center, Ganzi Tibetan Autonomous Prefecture People’s Hospital, Kangding, Sichuan 626000, P. R. China;
2. Sichuan Clinical Research Center for Hydatidosis, Kangding, Sichuan 626000, P. R. China;
3. Department of Liver And Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

CHEN Zheyu, Email: chenzheyu71@163.com

Keywords：

hepatic cystic echinococcosis; complete excision of the external capsule; efficacy; safety; partial hepatectomy

DOI：

10.7507/1007-9424.201911083

Video：

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Objective To analyze the efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis.Methods The clinical data of 90 patients with hepatic cystic echinococcosis admitted to our hospital from January 2016 to March 2018 were retrospectively analyzed. According to the different surgical methods, this patients were divided into two groups: the partial hepatectomy group and complete excision of the external capsule group, 45 cases in each group. The patient's general condition and the situation during hospitalization were analyzed, and the intraoperative conditions, postoperative complications, recurrence and mortality after one year in different surgical methods were compared.Results The operative time and intraoperative blood loss in the partial hepatectomy group was significantly longer or more than that in the complete excision of the external capsule group (P<0.05), respectively. There was no significant difference between the two groups in hospitalization time (P>0.05). The incidence of postoperative complications was 11.11% in the partial hepatectomy group and 8.88% in the complete excision of the external capsule group. There was no significant difference between the two groups (P>0.05). After 1 year of followed-up, the recurrence rate of the partial hepatectomy group was 4.44%, and there was no recurrence in the complete excision of the external capsule group, and there was no significant difference between the two groups (P>0.05). There was no death in both groups.Conclusions In the surgical treatment of hepatic cystic echinococcosis, the most appropriate surgical method should be selected according to the specific conditions of the patient, and the complete excision of the external capsule has higher therapeutic effect and safety in the treatment of hepatic echinococcosis. It is worthy of clinical promotion.

Citation： MA Zhi, WEI Gengfu, SHI Yiyang, CHEN Zheyu. Analysis on efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(1): 34-37. doi: 10.7507/1007-9424.201911083 Copy

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1. 温浩. 包虫病学. 北京: 人民卫生出版社, 2015: 起-止页.
2. 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.
3. 温浩, 邵英梅, 赵晋明, 等. 两型肝包虫病手术疗效 547 例临床分析. 中华消化外科志, 2007, 6(1): 13-18.
4. 母齐鸣, 贺伟, 侯桂敏, 等. 腹腔镜分别联合肝包虫内囊摘除术与解剖性肝切除治疗肝包虫病的临床疗效分析. 实用医院临床杂志, 2018, 15(3): 58-60.
5. 吴纲, 潘洪帅, 赵占学, 等. 四种不同手术方式治疗肝包虫病患者合并术后胆漏的疗效评价. 现代生物医学进展, 2018, 18(15): 2942-2945.
6. 马雅丽, 陈晓霞, 侯文文, 等. 囊型肝包虫病的多排螺旋CT诊断及术前影像检查的术前指导价值. 武警医学, 2018, 29(2): 120-123.
7. 任利, 胡涛, 邓勇, 等. 经内镜逆行胰胆管造影治疗泡型肝包虫病合并梗阻性黄疸的有效性分析. 中华消化内镜杂志, 2016, 33(11): 795-797.
8. 张子龙, 张静妮. 2012-2016年青海省包虫病住院病例回顾调查分析. 现代预防医学, 2017, 44(13): 2439-2443.
9. 阿依甫汗·阿汗, 哈丽娅, 李海涛, 等. 快速康复外科技术在肝囊型包虫病患者中的应用. 中华普通外科杂志, 2016, 31(9): 780-781.
10. 王冠, 罗兰云, 邹海波, 等. 中晚期肝泡型包虫病36例手术治疗体会. 中国普外基础与临床杂志, 2016, 23(11): 1379-1383.
11. 母齐鸣, 贺伟, 侯桂敏, 等. 腹腔镜解剖性肝切除与常规开腹肝切除术治疗肝包虫病的疗效分析. 实用医院临床杂志, 2018, 15(2): 131-133, 134.
12. 刘学军, 木尼热丁·艾则孜, 张新龙, 等. 加速康复外科理念用于肝囊型肝包虫病外囊剥离手术治疗的效果观察. 浙江医学, 2018, 40(5): 475-478.
13. 张丹, 宋九林, 杨平, 等. 不同手术方式治疗对高原地区肝包虫病患者围术期指标及术后复发率的影响. 局解手术学杂志, 2019, 28(3): 212-215.
14. 阿吉德, 柴金萍, 王皓, 等. 青海地区肝囊性包虫病术后IL-11、TNF-a、iNOS的变化及乌司他丁干预作用的临床研究. 新疆医科大学学报, 2019, 42(1): 111-115, 119.
15. 潘汝翀, 张发斌, 程时磊, 等. 砂生槐生物碱治疗继发性小鼠肝包虫病的实验研究. 中国病原生物学杂志, 2018, 13(3): 254-258.
16. 赵海蓉. 高原地区2例终末期泡型肝包虫病自体肝移植术围无肝期血流动力学变化的临床观察与护理. 贵州医药, 2019, 22(3): 483-484.
17. 陈克霏, 唐友银, 贾贵清, 等. 复杂泡型肝包虫根治性肝切除的MDT讨论. 中国普外基础与临床杂志, 2018, 25(1): 77-82.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on efficacy and safety of complete excision of the external capsule in the treatment of hepatic echinococcosis

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