eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
Bieżący numer Archiwum Artykuły zaakceptowane O czasopiśmie Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac
Portal dla gastroenterologów!
SCImago Journal & Country Rank
vol. 12
Poleć ten artykuł:
streszczenie artykułu:
Artykuł oryginalny

Surgical treatment of hepatic Echinococcus granulosus

Waldemar Patkowski, Maciej Krasnodębski, Michał Grąt, Łukasz Masior, Marek Krawczyk

Data publikacji online: 2017/09/30
Pełna treść artykułu
Pobierz cytowanie
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero

Introduction: Infections caused by metacestode stage of the Echinococcus granulosus in humans result in disease named cystic echinococcosis.

Aim: To present the outcomes of patients treated surgically for cystic echinococcosis of the liver.

Material and methods: One hundred and nineteen patients treated in the period between 1989 and 2014 due to E. granulosus infection in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw were selected for this retrospective study. Diagnostic protocol included imaging examinations, i.e. ultrasonography and computed tomography of the abdomen. Blood samples where used to proceed sequential enzyme-linked immunosorbent assay (ELISA) using Em2plus antigen as well as polymerase chain reaction (PCR) to detect E. granulosus.

Results: Surgery was the choice for treatment for almost all of the patients (98.3%). In 40 (34.2%) patients right hemihepatectomy, in 19 (16.2%) patients left hemihepatectomy, and in 21 (17.9%) patients bisegementectomy were performed. Postoperative complications occurred in 4 (3.4%) patients. In 3 patients biliary fistula requiring endoscopic treatment was observed, and 1 patient had subdiaphragmatic abscess successfully treated with drainage under ultrasound guidance. None of the patients died in the postoperative period, and the 1-, 5-, and 10-year survival rates were 100.0%, 90.9%, and 87.9%, respectively.

Conclusions: Surgical treatment of the symptomatic cystic echinococcosis is the modality of choice for E. granulosus infection of the liver. Despite substantial development of diagnostic methods and new management opportunities, echinococcal infection still presents a challenge for epidemiologists, pharmacologists, and clinicists.
Romig T, Ebi D, Wassermann M. Taxonomy and molecular epidemiology of Echinococcus granulosus sensu lato. Vet Parasitol 2015; 213: 76-84.
Craig PS, McManus DP, Lightowlers MW et al. Prevention and control of cystic echinococcosis. Lancet Infect Dis 2007; 7: 385-94.
McManus DP, Zhang W, Li J, et al. Echinococcosis. Lancet 2003; 362: 1295-304.
Brunetti E, Kern P, Vuitton DA; Writing Panel for the W-I. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Tropica 2010; 114: 1-16.
Eckert J, Gemmell MA, Meslin FX, Pawłowski ZS. WHO/OIE manual on echinococcosis in humans and animals: a public health problem of global concern World Organisation for Animal Health (Office International des Epizooties) and World Health Organization, 2001. Paris: World Organisation for Animal Health.
Larrieu EJ, Frider B. Human cystic echinococcosis: contributions to the natural history of the disease. Ann Trop Med Parasitol 2001; 95: 679-87.
Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of Echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev 2004; 17: 107-35.
Gołąb E, Czarkowski MP. Echinococcosis and cysticercosis in Poland in 2012. Prz Epidemiol 2012; 68: 279-82.
Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol 2012; 18: 1448-58.
Yagci G, Ustunsoz B, Kaymakcioglu N, et al. Results of surgical, laparoscopic, and percutaneous treatment for hydatid disease of the liver: 10 years experience with 355 patients. World J Gastroenterol 2005; 29: 1670-9.
Siracusano A, Teggi A, Ortona E. Human cystic echinococcosis: old problems and new perspectives. Interdiscip Perspect Infect Dis 2009; 2009: 474368.
Frider B, Larrieu E, Odriozola M. Long-term outcome of asymptomatic liver hydatidosis. J Hepatol 1999; 30: 228-31.
Working Group WHOI. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Tropica 2003; 85: 253-61.
Filice C, Brunetti E, Bruno R, Crippa FG; WHO Informal Working Group on Echinococcosis: PAIR Network. 2000. Percutaneous drainage of echinococcal cysts (PAIR-puncture, aspiration, injection, reaspiration): results of a worldwide survey for assessment of its saftey and efficacy. Gut 2000; 47: 156-7.
Georgiou GK, Lianos GD, Lazaros A, et al. Surgical management of hydatid liver disease. Int J Surg 2015; 20: 118-22.
Junghanss T, da Silva AM, Horton J, et al. Clinical management of cystic Echinococcosis: state of the art, problems, and perspectives. Am J Trop Med Hyg 2008; 79: 301-11.
Vavra P, Nowakova J, Ostruszka P, et al. Colorectal cancer liver metastases: laparoscopic and open radiofrequency-assisted surgery. Videosurgery Miniinv 2015; 10: 205-12.
Li H, Shao Y, Aji T, et al. Laparoscopic approach for total cystectomy in treating hepatic cystic echinococcosis. Parasite 2014; 21: 65.
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe