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intrabiliary rupture of hepatic hydatid cysts： results of 10 years＇ experience

Chinese Medical Journal 2013年第7期126卷 1384-1385页

作者： Tuerganaili Aji Ayifuhan Ahan SHAO Ying-mei RAN Bo JIANG Tie-ming WEN Hao Department of Hepatic Hydatid and Hepatobiliary Surgery Digestive and Vascular Surgery Centre First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang 830000 China Xinjiang Key Lab of Fundamental Medical Research and Xinjiang Hydatid Clinical Research Institute First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang 830000 China

intrabiliary rupture （IBR）is the most common and potentially fatal complication of Hepatic cysticechinococcosis （HCE） Early diagnosis and treatment of IBR is very important, since mortality is high when obstructio... 详细信息

关键词： intrabiliary rupture cystic echinococcosis hydatid disease diagnosis treatment

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intrabiliary rupture: An algorithm in the treatment of controversial complication of hepatic hydatidosis

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World Journal of Gastroenterology 2005年第16期11卷 2472-2476页

作者： Kenan Erzurumlu Adem Dervisoglu Cafer Polat Gokhan Senyurek Ibrahim Yetim Murat Hokelek Department of Surgery Medical School Ondokuz Mayis UniversityKurupelitSamsunTurkey

AIM: intrabiliary rupture (IBR) is a common and serious compli-cation of hepatic hydatid cyst. The incidence varies from 1% to 25%. The treatment of IBR is still controversial. We aimed to design an algorithm for the treatment of hepatic hydatidosis with IBR by reviewing our ***: Eight cases of IBR were analyzed *** were evaluated according to age, sex, clinical findings, cyst number and stage, abdominal ultrasonography and CT-scan, surgical methods, complica-tions, results and coincidental ***: Female/male ratio was 1/7. Mean age was 52.12±18.26 years (range 24-69 years). Right upper quadrant pain, flatulence, palpable hepatic mass were symptoms common in all patients. Cholestatic jaundice was found in four cases. In all patients, cyst evacuation and omento-plasty were performed, followed by either choledochod-uodenostomy, T-tube drainage, intracavitary suturing of the orifice, two cases in each. Whereas in two patients diagnosed post-operatively percutaneous drainage of biliary collection or ERCP and sphincteroplasty were added. Morbidity and hospital stay were higher in these ***: When the diagnosis of IBR can be done pre-or intra-operatively, morbidity decreases. If a biliary fistula is seen post-operatively, endoscopic procedures such as ERCP, sphincteroplasty or nasobiliary drainage can be applied.

关键词： intrabiliary rupture Hepatic hydatidcyst

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

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2012年第2期32卷 205-209页

作者：杨宏强唐景霞彭心宇张示杰孙红吕海龙李江陈孝平 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

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.

关键词： hepatic cystic hydatidosis intrabiliary rupture pericystectomy hepaticojejunostomy

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Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease

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World Journal of Gastroenterology 2014年第41期20卷 15253-15261页

作者： Kemal Dolay Sami Akbulut Department of Surgery Medipol University Faculty of Medicine Department of Surgery and Liver Transplant Institute Inonu University Faculty of MedicineTurgut Ozal Medical Center

Most cases of hepatic hydatid disease exhibit uncomplicated clinical course and ***,the diagnosis and management of complicated hepatic hydatid disease is a special *** of the most common and serious complications of hepatic hydatid disease is the rupture of the cyst into intrahepatic bile *** clinical appearance of intrabiliary rupture can range from asymptomatic to jaundice,cholecystitis,cholangitis,liver abscess,pancreatitis and *** treatments for major ruptures can result in high morbidity and mortality ***,ruptures that cannot be diagnosed preoperatively can induce complications such as biliary fistulae,biloma,cavitary infection and obstructive *** the past,these complications were diagnosed and treated by surgical ***,complications in both the pre- and postoperative periods are diagnosed and treated by non-invasive or minimally invasive *** clinical practice,endoscopic retrograde cholangiopancreatography(ERCP) is indicated for patients with preoperative frank intrabiliary rupture in which hydatid elements are clearly seen in the bile ducts,or for biliary adverse events after surgery,including persistent biliary fistulae and ***,controversy concerning routine preoperative ERCP and prophylactic endoscopic sphincterotomy in patients suspected of having minor cystobiliary communications still *** this article,the role of ERCP in the diagnosis and management of hepatic hydatid disease during the pre- and postoperative periods is reviewed.

关键词： Hydatid cyst Complications intrabiliary rupture Endoscopic retrograde cholangiopancreatography

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