Surgical management of complicated hydatid cysts of the liver  

作　　者：Ajaz A Malik Shams UL Bari Ruquia Amin Masooda Jan 

机构地区：[1]Department of Surgery,Sheri Kashmir Institute of Medical Sciences Soura,Srinagar,Kashmir 190006,India [2]Department of General Surgery,Sheri Kashmir Institute of Medical Sciences,Medical College Bemina,Srinagar,Kashmir 190006,India [3]Department of Social and Preventive Medicine,Sheri Kashmir Institute of Medical Sciences,Srinagar,Kashmir 190006,India [4]Department of Social and Preventive Medicine,Government Medical College Srinagar,Kashmir 190006,India

出　　处：《World Journal of Gastrointestinal Surgery》2010年第3期78-84,共7页世界胃肠外科杂志（英文版）（电子版）

摘　　要：AIM: To review the clinical presentation and surgical management of complicated hydatid cysts of the liver and to assess whether conservative surgery is adequate in the management of complicated hydatid cysts of liver.METHODS:The study was carried out at Sher-i-Kashmir Institute of Medical Science,Srinagar,Kashmir,India.Sixty nine patients with hydatid disease of the liver were surgically managed from April 2004 to October 2005 with a follow up period of three years.It included 27 men and 42 women with a median age of 35 years.An abdominal ultrasound,computed tomography and serology established diagnosis.Patients with jaundice and high suspicion of intrabiliary rupture were subjected to preoperative endoscopic retrograde cholangiography.Cysts with infection,rupture into the biliary tract and peritoneal cavity were categorized as complicated cysts.Eighteen patients(26%)had complicated cysts and formed the basis for this study.RESULTS:Common complications were infection(14%),intrabiliary rupture(9%)and intraperitoneal rupture(3%).All the patients with infected cysts presented with pain and fever.All the patients with intrabiliary rupture had jaundice,while only four with intrabiliary rupture had pain and only two had fever.Surgical procedures performed in complicated cysts were:infection-omentoplasty in three and external drainage in seven;intrabiliary rupture-omentoplasty in two and internal drainage in four patients.Two patients with intraperitoneal rupture underwent external drainage.There was no mortality.The postoperative morbidity was 50%in complicated cysts and 16%in uncomplicated cysts.CONCLUSION:Complicated hydatid cyst of the liver can be successfully managed surgically with good long term results.AIM: To review the clinical presentation and surgical management of complicated hydatid cysts of the liver and to assess whether conservative surgery is adequate in the management of complicated hydatid cysts of liver.METHODS: The study was carried out at Sher-i-Kashmir Institute of Medical Science, Srinagar, Kashmir, India. Sixty nine patients with hydatid disease of the liver were surgically managed from April 2004 to October 2005 with a follow up period of three years. It included 27 men and 42 women with a median age of 35 years. An abdominal ultrasound, computed tomography and serology established diagnosis. Patients with jaundice and high suspicion of intrabiliary rupture were subjected to preoperative endoscopic retrograde cholangiography. Cysts with infection, rupture into the biliary tract and peritoneal cavity were categorized as complicated cysts. Eighteen patients (26%) had complicated cysts and formed the basis for this study.RESULTS: Common complications were infection (14%), intrabiliary rupture (9%) and intraperitoneal rupture (3%). All the patients with infected cysts presented with pain and fever. All the patients with intrabiliary rupture had jaundice, while only four with intrabiliary rupture had pain and only two had fever. Surgical procedures performed in complicated cysts were: infection-omentoplasty in three and external drainage in seven; intrabiliary rupture-omentoplasty in two and internal drainage in four patients. Two patients with intraperitoneal rupture underwent external drainage. There was no mortality. The postoperative morbidity was 50% in complicated cysts and 16% in uncomplicated cysts.CONCLUSION: Complicated hydatid cyst of the liver can be successfully managed surgically with good long term results.

关 键 词：LIVER HYDATID DISEASE COMPLICATED LIVER HYDATID Drainage OPERATIVE TECHNIQUES 

分 类 号：R532.32[医药卫生—内科学]