The Clinical Analysis For The Different Surgical Treatment And Complication Against Human Hepatic Cystic Echinococcosis

Objective: To analyse and discuss the curative effect of different surgicalprocedures for hepatic cystic echinococcosis and postoperative complications against inhuman hepatic cystic echinococcosis.Methods: A retrospective analysis was conducted of287patients who underwent operative treatment at the First Affiliated Hospital ofXinjiang Medical University from January2009to August2011. The diagnosis was basedon the results of epidemiology history, clinical manifestation, typical imaging findingsand serum immunology examination. According to different operative methods,the287cases were divided into four groups: namely improved endocystectomy group (group A)were64cases, total cystectomy group(group B) were125cases, subtotalpericystectomy group(group C) were84cases,precise liver resection group (group D)were17cases. The operation time, peri-operative blood loss,the lenth of postoperativehospital stay, postoperative residual tube cavity complications (bile fistula, infection,effusion) and postoperative liver function, celiac spread planting, in situ recurrence anddeath of the2groups were compared. All data were analyzed by using the t test and thechi-square test. Results: Improved endocystectomy group (group A) was significantlyhigher than other surgical procedures in the postoperative complications with residualcavity and draining time (P＜0.05). Group A and C was superior to Group B and D in thepostoperative hospital stay, blood loss, operation time and postoperative liver function (P＜0.05). A total of286HCE cases (99.65%) were cured and1cases (0.35%)died.Conclusion:Total cystectomy is a reasonable and practicable surgical method forcompletely resolving recurrence and bile leak complications. Subtotal pericystetomy can effectively eliminate the residual cavity, while can reduce the operation difficulty andlower the surgical risk of total cyctectomy for the lesion with large vessels nearby or vitalorgans organization arounding. Liver resection can eradicate the cavity after stubborn bileleakage with tube or long-term repeatedly debridement and serious liver lesion. Ourresults suggest that cholangiography and common bile duct exploration through cysticduct can completely solve the cavity-related problems while avoiding T-tube relatedproblems.