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Treatment of Complicated Hepatic Cystic Hydatidosis with Intrabiliary Rupture by Pericystectomy in Combination with Roux-en-Y Hepaticojejunostomy

Treatment of Complicated Hepatic Cystic Hydatidosis with Intrabiliary Rupture by Pericystectomy in Combination with Roux-en-Y Hepaticojejunostomy

作     者:杨宏强 唐景霞 彭心宇 张示杰 孙红 吕海龙 李江 陈孝平 

作者机构:Center of Hepatic Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Department of Hepatobiliary Surgery the First Affiliated Hospital of the Medical College Shihezi University Department of Social Medicine School of Public Health Tongji Medical College Huazhong University of Science and Technol-ogy Department of Preventive Medicine of the Medical College Shihezi University 

出 版 物:《Journal of Huazhong University of Science and Technology(Medical Sciences)》 (华中科技大学学报(医学英德文版))

年 卷 期:2012年第32卷第2期

页      面:205-209页

核心收录:

学科分类:0831[工学-生物医学工程(可授工学、理学、医学学位)] 0710[理学-生物学] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 0805[工学-材料科学与工程(可授工学、理学学位)] 0703[理学-化学] 0836[工学-生物工程] 10[医学] 

基  金:supported by grants from The National Natural Science Foundation of China(No.81160199) the National SupProgram for Supporting Researches of Scienceand Technology of China(No.2009BAI82B06) Major Health Research Projects of Xinjiang Production and Con-struction Corps,Xinjiang,China(No.2010GG54) Ma-jor Research Projects of Shihezi University,Xinjiang,China(No.gxji2008-zdgg06) 

主  题:hepatic cystic hydatidosis intrabiliary rupture pericystectomy hepaticojejunostomy 

摘      要:This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ul-trosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments Ⅴ, Ⅵ in 6 cases, and segment Ⅳ in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2–4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.

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