Control Study of Clinical Effect of the Surgery with Laparoscope and Choledochoscope on Plateau Hepatic Hydatid Biloary Fistulas_West China Medical Journal

Authors：

 DANGBao-bao , QINWei ,  DONGJin , CHUXiao-mei

Department of Laparoscopic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, P. R. China;

Corresponding?author：

DONGJin, Email: qhdongjin@163.com

Keywords：

Laparoscopy; Choledochoscope; Liver hydatid disease; Biliary fi stula

DOI：

10.7507/1002-0179.20140381

Video：

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Objective To explore the effect of the surgery with laparoscope combined with choledochoscope on plateau hepatic hydatid biliary fistulas. Methods A total of 100 patients with liver hydatid disease diagnosed between January 2012 and June 2013 were divided into two groups according to the admitting time:laparoscope combined with choledochoscope group (combined group) and laparoscope group, with 50 patients in each group. The therapeutic results of the two groups were compared. Results A total of 186 biliary fistulas were found in the combined group during the operation, and there were 5 patients with biliary fistulas after the surgery; while 87 biliary fistulas were found in laparoscope group during the operation and there were 16 patients with biliary fistulas after the surgery. The difference in the occurrence rate of biliary fistulas after surgery between the two groups was significant (χ²=7.294, P=0.007). No infection of incisional wound was found in combined group but 5 infection was found in laparoscope group. The postoperative extubation time in the combined group and laparoscope group was (10.35±3.87) and (27.16±4.58) days, respectively, with a significant difference (t=12.538, P<0.001). Conclusion The laparoscope combined with choledochoscope is a minimally invasive and safe therapeutic option for plateau hepatic hydatid biliary fistulas.

Citation： DANGBao-bao, QINWei, DONGJin, CHUXiao-mei. Control Study of Clinical Effect of the Surgery with Laparoscope and Choledochoscope on Plateau Hepatic Hydatid Biloary Fistulas. West China Medical Journal, 2014, 29(7): 1238-1241. doi: 10.7507/1002-0179.20140381 Copy

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11.	Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cystic liver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
12.	黃志剛, 祝曉芬. 電動刨削器鼻內窺鏡下腺樣體切除術83例[J]. 陜西醫學雜志, 2004, 33(5):438-439.
13.	Cugat E, Olsina JJ, Rotellar F, et al. Initial results of the National Registry of Laparoscopic Liver Surgery[J]. Cirugía Espa?ola, 2005, 78(3):152-160.
14.	Yagci G, Ustunsoz B, Kaymakcioglu N, et al. Results of surgical,laparoscopic, and percutaneous treatment for hydatid disease of the liver:10 years experience with 355 patients[J]. World J Surg, 2005, 29(12):1670-1679.
15.	Ben Brahim M, Nouri A, Ksia A, et al. Management of multiple echinococcosis in childhood with albendazole and surgery[J]. J Pediatr Surg, 2008, 43(11):2024-2030.
16.	Chen W, Xusheng L. Laparoscopic surgical techniques in patients with hepatic hydatid cyst[J]. Am J Surg, 2007, 194(2):243-247.
17.	Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cysti cliver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
18.	廖霄斌, 趙晉明, 李介秋, 等. 腹腔鏡肝包蟲外囊剝離聯合膽囊切除1例[J]. 中國普通外科雜志, 2009, 9(9):931-932.
19.	李榮梓, 柴福錄, 肖毅, 等. 腹腔鏡技術在肝包蟲病治療中的應用. 腹腔鏡外科雜志[J]. 2009, 14(9):674-675.

1. K?ksal N, Müftüoglu T, Günerhan Y, et al. Management of intrabiliary ruptured hydatid disease of the liver[J]. Hepatogastroenterology, 2001, 48(40):1094-1096.
2. Bedirli A, Sakrak O, Sozuer EM, et al. Surgical management of spontaneous intrabiliary rupture of hydatid liver cysts[J]. Surg Today, 2002, 32(7):594-597.
3. Kayaalp C, Sengul N, Akoglu M. Importance of cyst content in hydatid liver surgery[J]. Arch Surg, 2002, 137(2):159-163.
4. 羅劍平. 木合然木. 肝包蟲囊腫126例臨床分析[J]. 中國普通外科雜, 2004, 13(3):236-237.
5. 余培東. 腹腔鏡行肝臟邊緣性包蟲囊腫切除術的療效觀察[J]. 寧夏醫學雜志, 2007, 29(12):1088-1089.
6. 李建勛, 高志剛, 李瑄, 等. 肝包蟲殘腔處理的探討[J]. 臨床軍醫雜志, 2009, 37(1):111, 116.
7. 柯重偉, 鄭成竹. 腹腔鏡外科手術學[M]. 上海:上海科學技術出版社, 2006:197.
8. 劉國禮. 現代微創外科學[M]. 北京:科學出版社, 2003:236-237.
9. 索朗次仁. 次仁倫珠, 扎西加措. 高原地區應用腹腔鏡治療肝包蟲病11例報告[J]. 腹腔鏡外科雜志, 2010, 15(2):119-120.
10. Saglam A. Laparoscopic treatment of liver hydatid cysts[J]. Surg Laparosc Endosc, 1996, 6(1):16-21.
11. Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cystic liver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
12. 黃志剛, 祝曉芬. 電動刨削器鼻內窺鏡下腺樣體切除術83例[J]. 陜西醫學雜志, 2004, 33(5):438-439.
13. Cugat E, Olsina JJ, Rotellar F, et al. Initial results of the National Registry of Laparoscopic Liver Surgery[J]. Cirugía Espa?ola, 2005, 78(3):152-160.
14. Yagci G, Ustunsoz B, Kaymakcioglu N, et al. Results of surgical,laparoscopic, and percutaneous treatment for hydatid disease of the liver:10 years experience with 355 patients[J]. World J Surg, 2005, 29(12):1670-1679.
15. Ben Brahim M, Nouri A, Ksia A, et al. Management of multiple echinococcosis in childhood with albendazole and surgery[J]. J Pediatr Surg, 2008, 43(11):2024-2030.
16. Chen W, Xusheng L. Laparoscopic surgical techniques in patients with hepatic hydatid cyst[J]. Am J Surg, 2007, 194(2):243-247.
17. Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cysti cliver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
18. 廖霄斌, 趙晉明, 李介秋, 等. 腹腔鏡肝包蟲外囊剝離聯合膽囊切除1例[J]. 中國普通外科雜志, 2009, 9(9):931-932.
19. 李榮梓, 柴福錄, 肖毅, 等. 腹腔鏡技術在肝包蟲病治療中的應用. 腹腔鏡外科雜志[J]. 2009, 14(9):674-675.

West China Medical Journal

Control Study of Clinical Effect of the Surgery with Laparoscope and Choledochoscope on Plateau Hepatic Hydatid Biloary Fistulas

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