FANG Dan 1 , CHEN Zheyu 1 , YANG Kangming 2 , CHEN Kefei 1 , HUANG Xiang 2 , MA Zhi 2 , LI Zhihong 2 , TANG Youyin 1 , XIE Jie 1 , WEI Gengfu 2
  • 1. Department of Hepatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
  • 2. Hepatobiliary Department, The People’s Hospital of Ganzi Tibetan Autonomous Prefecture of Sichuan Province, Ganzi, Sichuan 626000, P.R.China;
CHEN Zheyu, Email: chenzheyu71@163.com
hepatic alveolar echinococcosis; two-step hepatectomy; the second porta hepatis; the third porta hepatis
10.7507/1007-9424.201708020
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ObjectiveTo discuss the clinical application of two-step hepatectomy for hepatic alveolar echinococcosis which invaded the second and the third porta hepatis.MethodsThe clinical data of 60 patients with hepatic alveolar echinococcosis invaded the second and the third porta hepatis who treated with two-step hepatectomy in West China Hospital of Sichuan University and The People’s Hospital of Ganzi Tibetan Autonomous Prefecture of Sichuan Province from Jan. 2013 to Jun. 2017 were analyzed retrospectively.ResultsSixty patients had underwent radical hepatectomy successfully and no death happened during perioperative period. The average operative time was 309.17 min (150–475 min) and intraoperative blood loss was 586.67 mL (100–3 000 mL). Forty-eight patients blocked the blood flowing into the liver, the average blocking time was 25.85 min (15–50 min); 24 patients suffered red blood cell suspension, the average amount was 3.79 U (2–8 U), and 9 patients were infused with fresh frozen plasma, the average amount was 527.78 mL (350–850 mL). The average of hospital stays was 17.5 days (7–39 days) and average of hospitalization cost was 49 323.43 yuan (28 045.32–61 243.15 yuan). The liver function indicators returned to normal within 7 days after operation. After operation, 3 patients suffered from biliary fistula, 3 patients suffered from pleural effusion, 3 patients suffered from peritoneal effusion, 10 patients suffered from effusion. According to the rank of complication: 10 patients were defined as grade Ⅰ, 3 patients were defined as grade Ⅱ, 6 patients were defined as grade Ⅲa. The average follow-up time of 60 patients was 14.47 months (1–31 months). No recurrence and death occurred during follow-up period.ConclusionThe two-step hepatectomy in treatment of hepatic alveolar echinococcosis invaded the second and the third porta hepatis can avoid the large flucyuations of intraoperative blood pressure and other vital signs, can increase the safety of surgery and reduce the difficulty and risk of surgery.

Citation： FANG Dan, CHEN Zheyu, YANG Kangming, CHEN Kefei, HUANG Xiang, MA Zhi, LI Zhihong, TANG Youyin, XIE Jie, WEI Gengfu. The preliminary experience of two-step hepatectomy in treatment of hepatic alveolar echinococcosis invaded the second and the third porta hepatis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(9): 1066-1070. doi: 10.7507/1007-9424.201708020 Copy

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