复杂泡型肝包虫病MDT讨论  

Multiple disciplinary team discussion on complex hepatic alveolar echinococcosis

作　　者：陈见中 喻定刚 兰晓蓉 丁世荣[3] 雍记智 张泽奎[5] CHEN Jianzhong;YU Ding-gang;LAN Xiao-rong;DING Shi-rong;YONG Ji-zhi;ZHANG Ze-kui(Department of Hepatobiliary Pancreatic Surgery,The People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Sichuan 624000,China;Department of Ultrasonic Medicine,The People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Sichuan 624000,China;Department of Radiology,The People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Sichuan 624000,China;Department of Anesthesiology,The People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Sichuan 624000,China;Department of Critical Care Medicine,The People’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture,Sichuan 624000,China)

机构地区：[1]阿坝藏族羌族自治州人民医院肝胆外科,四川阿坝624000 [2]阿坝藏族羌族自治州人民医院超声医学科,四川阿坝624000 [3]阿坝藏族羌族自治州人民医院放射科,四川阿坝624000 [4]阿坝藏族羌族自治州人民医院麻醉科,四川阿坝624000 [5]阿坝藏族羌族自治州人民医院重症医学科,四川阿坝624000

出　　处：《肝胆胰外科杂志》2020年第3期152-156,共5页Journal of Hepatopancreatobiliary Surgery

基　　金：阿坝州科学技术和知识产权局项目(19YYJSYJ0005)。

摘　　要：目的通过MDT讨论提高复杂泡型肝包虫病治疗的效果。方法对阿坝藏族羌族自治州人民医院2019年6月收治的1例复杂泡型肝包虫患者在术前进行MDT讨论,进行术后治疗效果评价,并总结MDT在复杂泡型肝包虫病治疗中的作用。结果术前CT及MRCP检查发现肝包虫病病灶巨大,侵犯第一肝门,致左右肝管梗阻,严重黄疸,经MDT讨论术前行PTCD减黄,肝功能好转后行根治性右三肝切除术加肝管成形及肝管空肠Roux-en-Y吻合术。患者术后恢复良好,继续阿苯达唑治疗。结论复杂泡型肝包虫病手术根治性切除率低,通过MDT多学科讨论可提高外科治疗的有效性及安全性。Objective To improve the effect of surgical treatment for complex alveolarhepatic alveolar echinococcosis by multiple disciplinary team(MDT)discussion.Methods The clinical data of one case with complex hepatic alveolar echinococcosis were discussed by MDT,and the postoperative treatment effect was evaluated.The role of MDT in the treatment of complex hepatic alveolar echinococcosis was summarized.Results The preoperative CT and MRCP imaging suggested the large hepatic hydatid lesions,infringement of the first hepatic portal,left and right hepatic duct obstruction,and severe jaundice.After MDT discussion,preoperative percutaneous transhepatic cholangial drainage(PTCD)therapy was applied.After liver function improved,radical right trihepatectomy and Roux-en-Y hepaticoieiunostomy were performed.The postoperative recovery was good and albendazole therapy was continued.Conclusion Radical resection for complex hepatic alveolar echinococcosis is low.The application of of MDT can increase the efficacy and security of surgical treatment.

关 键 词：复杂泡型肝包虫病 多学科综合治疗 根治性右三肝切除术 肝管空肠Roux-en-Y吻合术 

分 类 号：R657.3[医药卫生—外科学]