細菌学および寄生虫学ジャーナル

概要

ヒト肝包虫症に対するさまざまな外科的アプローチの臨床的および血清学的結果

アムル・アブデルラウフ、アマニー・A・アブド・エル・アール、エマン・Y・ショウイブ、サマル・サティア、ニハル・A・ハナフィ、モハメド・ハッサーニ、ソヘアー・ショーマン

Background: Cystic echinococcosis or hydatidosis occurs as a result of infection by the larval stages of Ecchinococcus granulosus. Treatment approaches of hydatid cysts include the use of albendazole, surgery and/or medico-surgical procedures.

Objective: The present study aimed to investigate and evaluate partial pericystectomy, PAIR technique and combined PAIR technique followed by deroofing, evacuation of cysts and omentoplasty as three therapeutic approaches for treatment of hepatic hydatid cysts.

Methodology: The study was conducted on 54 patients presenting with hepatic hydatid cysts. Patients were included in 3 groups: group I (14 cases) subjected to partial pericystectomy, group II (23 cases) subjected to PAIR technique and group III (17 cases) subjected to PAIR technique followed by deroofing of the cysts and omentoplasty. Diagnosis of hydatid cysts was based on serological testing by ELISA, abdominal ultra-sound examination and parasitological examination of cysts contents. Morbidity, mortality, hospital stay, recurrence and postoperative complications were evaluated for each surgical procedure.

Results: Postoperative bleeding, infection, recurrence and prolonged hospital stay were reported in group I subjected to pericystectomy. Recurrence and postoperative bleeding were reported in group II with no postoperative infection and less hospital stay. No recurrence or postoperative complications were reported in cases included in group III.

Conclusion: Partial surgical procedure with deroofing, evacuation of cysts and omentoplasty performed in this work is recommended as a safe and effective method for entire elimination of parasite with minimal possibility for intra-peritoneal spillage.