Experience of reduced volume lesion resection combined with drug therapy in treatment of end-stage alveolar hepatic echinococcosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 HUANG Guoqiang , YE Xiezhihua , GUO Yamin , ZHAO Shunyun

Department of General Surgery, Qinghai Provincial People’s Hospital, Xining 810007, P. R. China;

Corresponding author：

HUANG Guoqiang, Email: 305437646@qq.com

Keywords：

end-stage alveolar hepatic echinococcosis; reduced volume lesion resection; anti-hydatid drug therapy

DOI：

10.7507/1007-9424.202009020

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Objective To summarize the therapeutic effect and clinical significance of reduced volume lesion resection combined with drug therapy for end-stage alveolar hepatic echinococcosis.Method Clinical data of 46 patients with end-stage alveolar hepatic echinococcosis who received treatment of reduced volume lesion resection combined with drug therapy at Department of General Surgery of Qinghai Provincial People’s Hospital from March 2013 to October 2019 were retrospectively analyzed.Results Among the 46 patients, 3 patients were lost to follow-up and 43 patients received follow-up. The follow-up time ranged from 3 to 79 months, with the median of 40 months. Fifteen patients died during the follow-up period, of which 5 patients with cerebral hydatid disease died during 16–36 months due to acute seizures and cerebral edema, 4 patients with multiple systemic metastases died during 9–36 months due to multiple organ failure, 2 patients with pulmonary echinococcosis died due to acute pulmonary embolism, 4 patients died in 2 years after operation due to recurrent biliary tract infection, other patients survived during follow-up period without distant organ metastasis.Conclusion Reduced volume lesion resection combined with drug therapy in treatment of end-stage alveolar hepatic echinococcosis can improve the patient’s quality of life, reduce the hospital cost, reduce the occurrence of postoperative complications, and shorten the length of hospital stay.

Citation： HUANG Guoqiang, YE Xiezhihua, GUO Yamin, ZHAO Shunyun. Experience of reduced volume lesion resection combined with drug therapy in treatment of end-stage alveolar hepatic echinococcosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 904-909. doi: 10.7507/1007-9424.202009020 Copy

1.	Hatipoglu S, Bulbuloglu B, Piskin T, et al. Living donor liver transplantation for alveolar echinococcus is a difficult procedure. Transplant Proc, 2013, 45(3): 1028-1030.
2.	Joliat GR, Melloul E, Petermann D, et al. Outcomes after liver resection for hepatic alveolar echinococcosis: a single-center cohort study. World J Surg, 2015, 39(10): 2529-2534.
3.	方丹, 陈哲宇, 杨康明, 等. 侵犯第二、三肝门的泡型肝包虫病行分步切除的初步经验. 中国普外基础与临床杂志, 2017, 24(9): 1066-1070.
4.	Du C, Liu Z, Yang X, et al. Hepatectomy for patients with alveolar echinococcosis: Long-term follow-up observations of 144 cases. Int J Surg, 2016, 35: 147-152.
5.	Kasai Y, Koshino I, Kawanishi N, et al. Alveolar echinococcosis of the liver; studies on 60 operated cases. Ann Surg, 1980, 191(2): 145-152.
6.	王文涛, 杨闯, 严律南. 肝泡型包虫病外科根治性治疗的新理念与策略. 中华医学杂志, 2018, 98(38): 3049-3051.
7.	牛祁光. 姑息性手术联合药物与单纯口服药物治疗晚期肝泡型包虫病的生存率的系统分析. 乌鲁木齐: 新疆医科大学, 2018.
8.	陈哲宇. 泡型肝包虫病的外科治疗现状. 中国普外基础与临床杂志, 2016, 23(5): 513-516.
9.	赵顺云, 阿吉德, 吴世乐, 等. 晚期肝泡型包虫病的治疗现状及进展. 中华肝胆外科杂志, 2020, 26(3): 233-236.
10.	王文涛, 杨先伟, 严律南. 离体肝切除联合自体肝移植治疗晚期肝泡型包虫病. 中国普外基础与临床杂志, 2017, 24(7): 792-794.
11.	阿吉德, 柴金萍, 王皓, 等. 解剖性肝切除治疗肝泡型包虫病临床价值研究. 中国实用外科杂志, 2019, 39(12): 1331-1334.
12.	玉苏甫卡迪尔·麦麦提尼加提. 自体肝移植治疗肝泡型包虫病的下腔静脉重建方式的临床研究. 乌鲁木齐: 新疆医科大学, 2020.
13.	Aji T, Dong JH, Shao YM, et al. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis. J Hepatol, 2018, 69(5): 1037-1046.
14.	陈克霏, 唐友银, 贾贵清, 等. 复杂泡型肝包虫根治性肝切除的MDT讨论. 中国普外基础与临床杂志, 2018, 25(1): 77-82.
15.	强巴旦增, 顾炯, 侯辉. 西藏山南市肝包虫病外科治疗经验. 肝胆外科杂志, 2019, 27(3): 225-227.
16.	李作安, 吐尔干艾力·阿吉, 冉博, 等. “减体积式病灶肝切除”治疗晚期肝巨大泡型包虫病的临床应用. 中国普通外科杂志, 2012, 21(7): 864-868.
17.	方丹, 陈哲宇, 曾勇, 等. 泡型肝包虫病的外科治疗. 中国普外基础与临床杂志, 2016, 23(5): 521-525.
18.	Ayifuhan A, Tuerganaili A, Jun C, et al. Surgical treatment for hepatic alveolar echinococcosis: report of 50 cases. Hepatogastroenterology, 2012, 59(115): 790-793.
19.	Buttenschoen K, Gruener B, Carli Buttenschoen D, et al. Palliative operation for the treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(1): 199-204.
20.	Pavlidis ET, Symeonidis N, Psarras K, et al. Huge echinococcal cyst of the liver managed by hepatectomy: Report of two cases. Int J Surg Case Rep, 2017, 31: 79-82.
21.	Du XL, Ma QJ, Wu T, et al. Treatment of hepatic cysts byB-ultrasound-guided radiofrequency ablation. Hepatobiliary Pancreat Dis Int, 2007, 6(3): 330-332.
22.	赵顺云, 郭亚民, 李冰. 手术联合阿苯达唑脂质体治疗晚期泡型肝包虫病. 中华肝胆外科杂志, 2015, 21(5): 321-323.
23.	邵英梅, 蒋铁民, 吐尔干艾力·阿吉, 等. 根治性及准根治性手术治疗终末期肝泡型包虫病. 中华消化外科杂志, 2011, 10(4): 296-298.
24.	张瀚之, 陈哲宇, 严律南, 等. 肝包虫病外科治疗的单中心经验. 中国普外基础与临床杂志, 2015, 22(2): 144-148.
25.	Bastid C, Ayela P, Sahel J. Percutaneous treatment of a complex hydatid cyst of the liver under sonographic control. Report of the first case. Gastroenterol Clin Biol, 2005, 29(2): 191-192.
26.	阿吉德, 柴金萍, 赵顺云, 等. 保留肝后下腔静脉的离体肝切除、自体肝移植术在治疗终末期肝泡型包虫病中的临床应用. 中华肝胆外科杂志, 2019, 25(11): 860-862.
27.	Wen H, New RR, Muhmut M, et al. Pharmacology and efficacy of liposome-entrapped albendazole in experimental secondary alveolar echinococcosis and effect of co-administration with cimetidine. Parasitology, 1996, 113(Pt 2): 111-121.
28.	Brunetti E, Filice C. Radiofrequency thermal ablation of echinococcal liver cysts. Lancet, 2001, 358(9291): 1464.
29.	Shen S, Kong J, Zhao J, et al. Outcomes of different surgical resection techniques for end-stage hepatic alveolar echinococcosis with inferior vena cava invasion. HPB (Oxford), 2019, 21(9): 1219-1229.

1. Hatipoglu S, Bulbuloglu B, Piskin T, et al. Living donor liver transplantation for alveolar echinococcus is a difficult procedure. Transplant Proc, 2013, 45(3): 1028-1030.
2. Joliat GR, Melloul E, Petermann D, et al. Outcomes after liver resection for hepatic alveolar echinococcosis: a single-center cohort study. World J Surg, 2015, 39(10): 2529-2534.
3. 方丹, 陈哲宇, 杨康明, 等. 侵犯第二、三肝门的泡型肝包虫病行分步切除的初步经验. 中国普外基础与临床杂志, 2017, 24(9): 1066-1070.
4. Du C, Liu Z, Yang X, et al. Hepatectomy for patients with alveolar echinococcosis: Long-term follow-up observations of 144 cases. Int J Surg, 2016, 35: 147-152.
5. Kasai Y, Koshino I, Kawanishi N, et al. Alveolar echinococcosis of the liver; studies on 60 operated cases. Ann Surg, 1980, 191(2): 145-152.
6. 王文涛, 杨闯, 严律南. 肝泡型包虫病外科根治性治疗的新理念与策略. 中华医学杂志, 2018, 98(38): 3049-3051.
7. 牛祁光. 姑息性手术联合药物与单纯口服药物治疗晚期肝泡型包虫病的生存率的系统分析. 乌鲁木齐: 新疆医科大学, 2018.
8. 陈哲宇. 泡型肝包虫病的外科治疗现状. 中国普外基础与临床杂志, 2016, 23(5): 513-516.
9. 赵顺云, 阿吉德, 吴世乐, 等. 晚期肝泡型包虫病的治疗现状及进展. 中华肝胆外科杂志, 2020, 26(3): 233-236.
10. 王文涛, 杨先伟, 严律南. 离体肝切除联合自体肝移植治疗晚期肝泡型包虫病. 中国普外基础与临床杂志, 2017, 24(7): 792-794.
11. 阿吉德, 柴金萍, 王皓, 等. 解剖性肝切除治疗肝泡型包虫病临床价值研究. 中国实用外科杂志, 2019, 39(12): 1331-1334.
12. 玉苏甫卡迪尔·麦麦提尼加提. 自体肝移植治疗肝泡型包虫病的下腔静脉重建方式的临床研究. 乌鲁木齐: 新疆医科大学, 2020.
13. Aji T, Dong JH, Shao YM, et al. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis. J Hepatol, 2018, 69(5): 1037-1046.
14. 陈克霏, 唐友银, 贾贵清, 等. 复杂泡型肝包虫根治性肝切除的MDT讨论. 中国普外基础与临床杂志, 2018, 25(1): 77-82.
15. 强巴旦增, 顾炯, 侯辉. 西藏山南市肝包虫病外科治疗经验. 肝胆外科杂志, 2019, 27(3): 225-227.
16. 李作安, 吐尔干艾力·阿吉, 冉博, 等. “减体积式病灶肝切除”治疗晚期肝巨大泡型包虫病的临床应用. 中国普通外科杂志, 2012, 21(7): 864-868.
17. 方丹, 陈哲宇, 曾勇, 等. 泡型肝包虫病的外科治疗. 中国普外基础与临床杂志, 2016, 23(5): 521-525.
18. Ayifuhan A, Tuerganaili A, Jun C, et al. Surgical treatment for hepatic alveolar echinococcosis: report of 50 cases. Hepatogastroenterology, 2012, 59(115): 790-793.
19. Buttenschoen K, Gruener B, Carli Buttenschoen D, et al. Palliative operation for the treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(1): 199-204.
20. Pavlidis ET, Symeonidis N, Psarras K, et al. Huge echinococcal cyst of the liver managed by hepatectomy: Report of two cases. Int J Surg Case Rep, 2017, 31: 79-82.
21. Du XL, Ma QJ, Wu T, et al. Treatment of hepatic cysts byB-ultrasound-guided radiofrequency ablation. Hepatobiliary Pancreat Dis Int, 2007, 6(3): 330-332.
22. 赵顺云, 郭亚民, 李冰. 手术联合阿苯达唑脂质体治疗晚期泡型肝包虫病. 中华肝胆外科杂志, 2015, 21(5): 321-323.
23. 邵英梅, 蒋铁民, 吐尔干艾力·阿吉, 等. 根治性及准根治性手术治疗终末期肝泡型包虫病. 中华消化外科杂志, 2011, 10(4): 296-298.
24. 张瀚之, 陈哲宇, 严律南, 等. 肝包虫病外科治疗的单中心经验. 中国普外基础与临床杂志, 2015, 22(2): 144-148.
25. Bastid C, Ayela P, Sahel J. Percutaneous treatment of a complex hydatid cyst of the liver under sonographic control. Report of the first case. Gastroenterol Clin Biol, 2005, 29(2): 191-192.
26. 阿吉德, 柴金萍, 赵顺云, 等. 保留肝后下腔静脉的离体肝切除、自体肝移植术在治疗终末期肝泡型包虫病中的临床应用. 中华肝胆外科杂志, 2019, 25(11): 860-862.
27. Wen H, New RR, Muhmut M, et al. Pharmacology and efficacy of liposome-entrapped albendazole in experimental secondary alveolar echinococcosis and effect of co-administration with cimetidine. Parasitology, 1996, 113(Pt 2): 111-121.
28. Brunetti E, Filice C. Radiofrequency thermal ablation of echinococcal liver cysts. Lancet, 2001, 358(9291): 1464.
29. Shen S, Kong J, Zhao J, et al. Outcomes of different surgical resection techniques for end-stage hepatic alveolar echinococcosis with inferior vena cava invasion. HPB (Oxford), 2019, 21(9): 1219-1229.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience of reduced volume lesion resection combined with drug therapy in treatment of end-stage alveolar hepatic echinococcosis

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