Research advances in multimodal surgical treatment of hepatic alveolar echinococcosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HE Yang ,  WANG Wentao

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Wentao, Email: wwt02@163.com

Keywords：

hepatic alveolar echinococcosis; multimodal surgical treatment; multi-disciplinary treatment; autologous liver transplantation; review

DOI：

10.7507/1007-9424.202011091

Video：

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Objective To summarize the research status and new directions of surgical treatment of hepatic alveolar echinococcosis (HAE) in clinic, and to provide reference for further research in improving the rate of radical surgery.Method The recent literatures on the studies of HAE were reviewed.Results Although the biological behavior of HAE was similar to that of malignant tumor, the clinical symptoms appeared late as the intrahepatic lesions often grow slowly. At present, the treatment of this disease was mainly surgical operation, among which radical resection was the first choice. Drug therapy was also of great value in controlling disease progression and recurrence. In recent years, with the progress of surgical technology, the surgical method had gradually developed to the direction of multi-mode combination, especially for those cases that had not been able to perform conventional radical surgery before.Conclusion The treatment concept of clinical multi-mode combination can benefit more patients, even achieve clinical radical resection, and improve the rate of radical resection.

Citation： HE Yang, WANG Wentao. Research advances in multimodal surgical treatment of hepatic alveolar echinococcosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(9): 1243-1248. doi: 10.7507/1007-9424.202011091 Copy

1.	王立英, 伍卫平, 朱雪花. 2004-2008年全国包虫病疫情分析. 中国人兽共患病学报, 2010, 26(7): 699-702.
2.	Deplazes P, Rinaldi L, Alvarez Rojas CA, et al. Global distribution of alveolar and cystic echinococcosis. Adv Parasitol, 2017, 95: 315-493.
3.	张朝阳. 肝泡型棘球蚴病的治疗进展. 人人健康, 2020, 4(8): 295.
4.	Craig PS, Giraudoux P, Wang ZH, et al. Echinococcosis transmission on the Tibetan Plateau. Adv Parasitol, 2019, 104: 165-246.
5.	何伟, 尚婧晔, 黄燕, 等. 2007-2013年四川省包虫病疫情监测结果分析. 预防医学情报杂志, 2016, 32(8): 798-800.
6.	喻文杰, 王谦, 廖沙, 等. 2017年四川省石渠县包虫病患病情况现状调查. 预防医学情报杂志, 2018, 34(5): 545-549.
7.	Silva MA, Mirza DF, Bramhall SR, et al. Treatment of hydatid disease of the liver. Evaluation of a UK experience. Dig Surg, 2004, 21(3): 227-233, 233-234.
8.	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.
9.	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.
10.	Bresson-Hadni S, Koch S, Miguet JP, et al. Indications and results of liver transplantation for Echinococcus alveolar infection: an overview. Langenbecks Arch Surg, 2003, 388(4): 231-238.
11.	温浩, 邵英梅, 赵晋明, 等. 两型肝包虫病手术疗效547例临床分析. 中华消化外科杂志, 2007, 6(1): 13-18.
12.	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.
13.	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.
14.	Zeng X, Yang X, Yang P, et al. Individualized biliary reconstruction techniques in autotransplantation for end-stage hepatic alveolar echinococcosis. HPB (Oxford), 2020, 22(4): 578-587.
15.	Qiu Y, Yang X, Shen S, et al. Vascular infiltration-based surgical planning in treating end-stage hepatic alveolar echinococcosis with ex vivo liver resection and autotransplantation. Surgery, 2019, 165(5): 889-896.
16.	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.
17.	Wang T, Li G, Fu Z, et al. Surgical treatment of extensive hepatic alveolar echinococcosis using a three-dimensional visualization technique combined with allograft blood vessels: A case report. Medicine (Baltimore), 2020, 99(31): e21336.
18.	Greco S, Cannella R, Giambelluca D, et al. Complications of hepatic echinococcosis: multimodality imaging approach. Insights Imaging, 2019, 10(1): 113.
19.	Graeter T, Shi R, Bao H, et al. Intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis: a multicenter cohort study. Acta Radiol, 2020: 284185120951958.
20.	Kern P, Wen H, Sato N, et al. WHO classification of alveolar echinococcosis: principles and application. Parasitol Int, 2006, 55 Suppl: S283-S287.
21.	四川省包虫病临床医学研究中心, 四川省医师协会包虫病专业委员会. 泡型肝包虫病诊疗专家共识 (2020版). 中国普外基础与临床杂志, 2020, 27(1): 13-17.
22.	Yang X, Wang T, Kong J, et al. Resection of retrohepatic inferior vena cava without reconstruction in ex vivo liver resection and autotransplantation: a retrospective study. BMC Surg, 2020, 20(1): 56.
23.	Sadrizadeh A, Haghi SZ, Masuom SH, et al. Evaluation of the effect of pulmonary hydatid cyst location on the surgical technique approaches. Lung India, 2014, 31(4): 361-365.
24.	Yang YR, McManus DP, Huang Y, et al. Echinococcus granulosus infection and options for control of cystic echinococcosis in Tibetan communities of Western Sichuan Province, China. PLoS Negl Trop Dis, 2009, 3(4): e426.
25.	Buttenschoen K, Carli Buttenschoen D, Gruener B, et al. Long-term experience on surgical treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(4): 689-698.
26.	四川省包虫病临床医学研究中心, 四川省医师协会包虫病专业委员会. 复杂肝泡型包虫病诊疗专家共识 (2020版). 中国普外基础与临床杂志, 2020, 27(1): 18-23.
27.	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.
28.	Chen KF, Tang YY, Wang R, et al. The choose of different surgical therapies of hepatic alveolar echinococcosis: A single-center retrospective case-control study. Medicine (Baltimore), 2018, 97(8): e0033.
29.	Gruttadauria S, Vasta F, Minervini MI, et al. Significance of the effective remnant liver volume in major hepatectomies. Am Surg, 2005, 71(3): 235-240.
30.	Shen HD, Chen KF, Li B, et al. Two-stage hepatectomy for multiple giant alveolar echinococcosis. Medicine (Baltimore), 2017, 96(33): e7819.
31.	Moreno Berggren M, Isaksson B, Nyman R, et al. Portal vein embolization with n-butyl-cyanoacrylate before hepatectomy: a single-center retrospective analysis of 46 consecutive patients. Acta Radiol, 2020: 284185120953802.
32.	王瑞涛, 刘昌, 张晓刚, 等. ALPPS在肝泡型包虫病中的应用. 中华肝脏外科手术学电子杂志, 2018, 7(2): 127-132.
33.	Schadde E, Ardiles V, Slankamenac K, et al. ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: results of a multicenter analysis. World J Surg, 2014, 38(6): 1510-1519.
34.	Troja A, Khatib-Chahidi K, El-Sourani N, et al. ALPPS and similar resection procedures in treating extensive hepatic metastases: our own experiences and critical discussion. Int J Surg, 2014, 12(9): 1020-1022.
35.	Ikegami T, Onda S, Furukawa K, et al. Small-for-size graft, small-for-size syndrome and inflow modulation in living donor liver transplantation. J Hepatobiliary Pancreat Sci, 2020, 27(11): 799-809.
36.	Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg, 2012, 255(3): 405-414.
37.	Schadde E, Ardiles V, Robles-Campos R, et al. Early survival and safety of ALPPS: first report of the International ALPPS Registry. Ann Surg, 2014, 260(5): 829-836, 836-838.
38.	Xiang F, Hu ZM. Chance and challenge of associating liver partition and portal vein ligation for staged hepatectomy. Hepatobiliary Pancreat Dis Int, 2019, 18(3): 214-222.
39.	Akbulut S, Cicek E, Kolu M, et al. Associating liver partition and portal vein ligation for staged hepatectomy for extensive alveolar echinococcosis: First case report in the literature. World J Gastrointest Surg, 2018, 10(1): 1-5.
40.	Shinkawa H, Takemura S, Tanaka S, et al. Portal vein embolization: history and current indications. Visc Med, 2017, 33(6): 414-417.
41.	Meinel TR, Gottstein B, Geib V, et al. Vertebral alveolar echinococcosis-a case report, systematic analysis, and review of the literature. Lancet Infect Dis, 2018, 18(3): e87-e98.
42.	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.
43.	Aydin U, Yazici P, Onen Z, et al. The optimal treatment of hydatid cyst of the liver: radical surgery with a significant reduced risk of recurrence. Turk J Gastroenterol, 2008, 19(1): 33-39.
44.	Tagliacozzo S, Miccini M, Amore Bonapasta S, et al. Surgical treatment of hydatid disease of the liver: 25 years of experience. Am J Surg, 2011, 201(6): 797-804.
45.	姚秉礼. 肝泡状棘球蚴的诊断和治疗. 中华外科杂志, 1965, 13(5): 460-461.
46.	Kadry Z, Renner EC, Bachmann LM, et al. Evaluation of treatment and long-term follow-up in patients with hepatic alveolar echinococcosis. Br J Surg, 2005, 92(9): 1110-1116.
47.	任利, 胡涛, 邓勇, 等. 经内镜逆行胰胆管造影治疗泡型肝包虫病合并梗阻性黄疸的有效性分析. 中华消化内镜杂志, 2016, 33(11): 795-797.
48.	Zhang Y, Xie P, Yang C, et al. Percutaneous stenting of left hepatic vein followed by Ex vivo Liver Resection and Autotransplantation in a patient with hepatic alveolar echinococcosis with Budd-Chiari syndrome. Int J Surg Case Rep, 2020, 68: 251-256.
49.	Gillet M, Miguet JP, Mantion G, et al. Orthotopic liver transplantation in alveolar echinococcosis of the liver: analysis of a series of six patients. Transplant Proc, 1988, 20(1 Suppl 1): 573-576.
50.	温浩, 栾梅香, 王喜艳, 等. 国内首例肝移植治疗肝泡型包虫病报告. 地方病通报, 2001, 16(3): 100.
51.	Chauchet A, Grenouillet F, Knapp J, et al. Increased incidence and characteristics of alveolar echinococcosis in patients with immunosuppression-associated conditions. Clin Infect Dis, 2014, 59(8): 1095-1104.
52.	Vuitton DA, Zhang SL, Yang Y, et al. Survival strategy of Echinococcus multilocularis in the human host. Parasitol Int, 2006, 55 Suppl: S51-S55.
53.	温浩. 肝包虫病诊断和手术治疗新进展. 中华消化外科杂志, 2011, 10(4): 290-292.
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55.	Shen S, Kong J, Qiu Y, et al. Ex vivo liver resection and autotransplantation versus allotransplantation for end-stage hepatic alveolar echinococcosis. Int J Infect Dis, 2019, 79: 87-93.
56.	Yang X, Qiu Y, Huang B, et al. Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases. Am J Transplant, 2018, 18(7): 1668-1679.
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1. 王立英, 伍卫平, 朱雪花. 2004-2008年全国包虫病疫情分析. 中国人兽共患病学报, 2010, 26(7): 699-702.
2. Deplazes P, Rinaldi L, Alvarez Rojas CA, et al. Global distribution of alveolar and cystic echinococcosis. Adv Parasitol, 2017, 95: 315-493.
3. 张朝阳. 肝泡型棘球蚴病的治疗进展. 人人健康, 2020, 4(8): 295.
4. Craig PS, Giraudoux P, Wang ZH, et al. Echinococcosis transmission on the Tibetan Plateau. Adv Parasitol, 2019, 104: 165-246.
5. 何伟, 尚婧晔, 黄燕, 等. 2007-2013年四川省包虫病疫情监测结果分析. 预防医学情报杂志, 2016, 32(8): 798-800.
6. 喻文杰, 王谦, 廖沙, 等. 2017年四川省石渠县包虫病患病情况现状调查. 预防医学情报杂志, 2018, 34(5): 545-549.
7. Silva MA, Mirza DF, Bramhall SR, et al. Treatment of hydatid disease of the liver. Evaluation of a UK experience. Dig Surg, 2004, 21(3): 227-233, 233-234.
8. 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.
9. 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.
10. Bresson-Hadni S, Koch S, Miguet JP, et al. Indications and results of liver transplantation for Echinococcus alveolar infection: an overview. Langenbecks Arch Surg, 2003, 388(4): 231-238.
11. 温浩, 邵英梅, 赵晋明, 等. 两型肝包虫病手术疗效547例临床分析. 中华消化外科杂志, 2007, 6(1): 13-18.
12. 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.
13. 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.
14. Zeng X, Yang X, Yang P, et al. Individualized biliary reconstruction techniques in autotransplantation for end-stage hepatic alveolar echinococcosis. HPB (Oxford), 2020, 22(4): 578-587.
15. Qiu Y, Yang X, Shen S, et al. Vascular infiltration-based surgical planning in treating end-stage hepatic alveolar echinococcosis with ex vivo liver resection and autotransplantation. Surgery, 2019, 165(5): 889-896.
16. 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.
17. Wang T, Li G, Fu Z, et al. Surgical treatment of extensive hepatic alveolar echinococcosis using a three-dimensional visualization technique combined with allograft blood vessels: A case report. Medicine (Baltimore), 2020, 99(31): e21336.
18. Greco S, Cannella R, Giambelluca D, et al. Complications of hepatic echinococcosis: multimodality imaging approach. Insights Imaging, 2019, 10(1): 113.
19. Graeter T, Shi R, Bao H, et al. Intrahepatic manifestation and distant extrahepatic disease in alveolar echinococcosis: a multicenter cohort study. Acta Radiol, 2020: 284185120951958.
20. Kern P, Wen H, Sato N, et al. WHO classification of alveolar echinococcosis: principles and application. Parasitol Int, 2006, 55 Suppl: S283-S287.
21. 四川省包虫病临床医学研究中心, 四川省医师协会包虫病专业委员会. 泡型肝包虫病诊疗专家共识 (2020版). 中国普外基础与临床杂志, 2020, 27(1): 13-17.
22. Yang X, Wang T, Kong J, et al. Resection of retrohepatic inferior vena cava without reconstruction in ex vivo liver resection and autotransplantation: a retrospective study. BMC Surg, 2020, 20(1): 56.
23. Sadrizadeh A, Haghi SZ, Masuom SH, et al. Evaluation of the effect of pulmonary hydatid cyst location on the surgical technique approaches. Lung India, 2014, 31(4): 361-365.
24. Yang YR, McManus DP, Huang Y, et al. Echinococcus granulosus infection and options for control of cystic echinococcosis in Tibetan communities of Western Sichuan Province, China. PLoS Negl Trop Dis, 2009, 3(4): e426.
25. Buttenschoen K, Carli Buttenschoen D, Gruener B, et al. Long-term experience on surgical treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(4): 689-698.
26. 四川省包虫病临床医学研究中心, 四川省医师协会包虫病专业委员会. 复杂肝泡型包虫病诊疗专家共识 (2020版). 中国普外基础与临床杂志, 2020, 27(1): 18-23.
27. 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.
28. Chen KF, Tang YY, Wang R, et al. The choose of different surgical therapies of hepatic alveolar echinococcosis: A single-center retrospective case-control study. Medicine (Baltimore), 2018, 97(8): e0033.
29. Gruttadauria S, Vasta F, Minervini MI, et al. Significance of the effective remnant liver volume in major hepatectomies. Am Surg, 2005, 71(3): 235-240.
30. Shen HD, Chen KF, Li B, et al. Two-stage hepatectomy for multiple giant alveolar echinococcosis. Medicine (Baltimore), 2017, 96(33): e7819.
31. Moreno Berggren M, Isaksson B, Nyman R, et al. Portal vein embolization with n-butyl-cyanoacrylate before hepatectomy: a single-center retrospective analysis of 46 consecutive patients. Acta Radiol, 2020: 284185120953802.
32. 王瑞涛, 刘昌, 张晓刚, 等. ALPPS在肝泡型包虫病中的应用. 中华肝脏外科手术学电子杂志, 2018, 7(2): 127-132.
33. Schadde E, Ardiles V, Slankamenac K, et al. ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: results of a multicenter analysis. World J Surg, 2014, 38(6): 1510-1519.
34. Troja A, Khatib-Chahidi K, El-Sourani N, et al. ALPPS and similar resection procedures in treating extensive hepatic metastases: our own experiences and critical discussion. Int J Surg, 2014, 12(9): 1020-1022.
35. Ikegami T, Onda S, Furukawa K, et al. Small-for-size graft, small-for-size syndrome and inflow modulation in living donor liver transplantation. J Hepatobiliary Pancreat Sci, 2020, 27(11): 799-809.
36. Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg, 2012, 255(3): 405-414.
37. Schadde E, Ardiles V, Robles-Campos R, et al. Early survival and safety of ALPPS: first report of the International ALPPS Registry. Ann Surg, 2014, 260(5): 829-836, 836-838.
38. Xiang F, Hu ZM. Chance and challenge of associating liver partition and portal vein ligation for staged hepatectomy. Hepatobiliary Pancreat Dis Int, 2019, 18(3): 214-222.
39. Akbulut S, Cicek E, Kolu M, et al. Associating liver partition and portal vein ligation for staged hepatectomy for extensive alveolar echinococcosis: First case report in the literature. World J Gastrointest Surg, 2018, 10(1): 1-5.
40. Shinkawa H, Takemura S, Tanaka S, et al. Portal vein embolization: history and current indications. Visc Med, 2017, 33(6): 414-417.
41. Meinel TR, Gottstein B, Geib V, et al. Vertebral alveolar echinococcosis-a case report, systematic analysis, and review of the literature. Lancet Infect Dis, 2018, 18(3): e87-e98.
42. 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.
43. Aydin U, Yazici P, Onen Z, et al. The optimal treatment of hydatid cyst of the liver: radical surgery with a significant reduced risk of recurrence. Turk J Gastroenterol, 2008, 19(1): 33-39.
44. Tagliacozzo S, Miccini M, Amore Bonapasta S, et al. Surgical treatment of hydatid disease of the liver: 25 years of experience. Am J Surg, 2011, 201(6): 797-804.
45. 姚秉礼. 肝泡状棘球蚴的诊断和治疗. 中华外科杂志, 1965, 13(5): 460-461.
46. Kadry Z, Renner EC, Bachmann LM, et al. Evaluation of treatment and long-term follow-up in patients with hepatic alveolar echinococcosis. Br J Surg, 2005, 92(9): 1110-1116.
47. 任利, 胡涛, 邓勇, 等. 经内镜逆行胰胆管造影治疗泡型肝包虫病合并梗阻性黄疸的有效性分析. 中华消化内镜杂志, 2016, 33(11): 795-797.
48. Zhang Y, Xie P, Yang C, et al. Percutaneous stenting of left hepatic vein followed by Ex vivo Liver Resection and Autotransplantation in a patient with hepatic alveolar echinococcosis with Budd-Chiari syndrome. Int J Surg Case Rep, 2020, 68: 251-256.
49. Gillet M, Miguet JP, Mantion G, et al. Orthotopic liver transplantation in alveolar echinococcosis of the liver: analysis of a series of six patients. Transplant Proc, 1988, 20(1 Suppl 1): 573-576.
50. 温浩, 栾梅香, 王喜艳, 等. 国内首例肝移植治疗肝泡型包虫病报告. 地方病通报, 2001, 16(3): 100.
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52. Vuitton DA, Zhang SL, Yang Y, et al. Survival strategy of Echinococcus multilocularis in the human host. Parasitol Int, 2006, 55 Suppl: S51-S55.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research advances in multimodal surgical treatment of hepatic alveolar echinococcosis

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