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

Video：

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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, 陳哲宇, 楊康明, 等. 侵犯第二、三肝門的泡型肝包蟲病行分步切除的初步經驗. 中國普外基礎與臨床雜志, 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.	王文濤, 楊闖, 嚴律南. 肝泡型包蟲病外科根治性治療的新理念與策略. 中華醫學雜志, 2018, 98(38): 3049-3051.
7.	牛祁光. 姑息性手術聯合藥物與單純口服藥物治療晚期肝泡型包蟲病的生存率的系統分析. 烏魯木齊: 新疆醫科大學, 2018.
8.	陳哲宇. 泡型肝包蟲病的外科治療現狀. 中國普外基礎與臨床雜志, 2016, 23(5): 513-516.
9.	趙順云, 阿吉德, 吳世樂, 等. 晚期肝泡型包蟲病的治療現狀及進展. 中華肝膽外科雜志, 2020, 26(3): 233-236.
10.	王文濤, 楊先偉, 嚴律南. 離體肝切除聯合自體肝移植治療晚期肝泡型包蟲病. 中國普外基礎與臨床雜志, 2017, 24(7): 792-794.
11.	阿吉德, 柴金萍, 王皓, 等. 解剖性肝切除治療肝泡型包蟲病臨床價值研究. 中國實用外科雜志, 2019, 39(12): 1331-1334.
12.	玉蘇甫卡迪爾·麥麥提尼加提. 自體肝移植治療肝泡型包蟲病的下腔靜脈重建方式的臨床研究. 烏魯木齊: 新疆醫科大學, 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.	陳克霏, 唐友銀, 賈貴清, 等. 復雜泡型肝包蟲根治性肝切除的MDT討論. 中國普外基礎與臨床雜志, 2018, 25(1): 77-82.
15.	強巴旦增, 顧炯, 侯輝. 西藏山南市肝包蟲病外科治療經驗. 肝膽外科雜志, 2019, 27(3): 225-227.
16.	李作安, 吐爾干艾力·阿吉, 冉博, 等. “減體積式病灶肝切除”治療晚期肝巨大泡型包蟲病的臨床應用. 中國普通外科雜志, 2012, 21(7): 864-868.
17.	方丹, 陳哲宇, 曾勇, 等. 泡型肝包蟲病的外科治療. 中國普外基礎與臨床雜志, 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.	趙順云, 郭亞民, 李冰. 手術聯合阿苯達唑脂質體治療晚期泡型肝包蟲病. 中華肝膽外科雜志, 2015, 21(5): 321-323.
23.	邵英梅, 蔣鐵民, 吐爾干艾力·阿吉, 等. 根治性及準根治性手術治療終末期肝泡型包蟲病. 中華消化外科雜志, 2011, 10(4): 296-298.
24.	張瀚之, 陳哲宇, 嚴律南, 等. 肝包蟲病外科治療的單中心經驗. 中國普外基礎與臨床雜志, 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, 趙順云, 等. 保留肝后下腔靜脈的離體肝切除、自體肝移植術在治療終末期肝泡型包蟲病中的臨床應用. 中華肝膽外科雜志, 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, 陳哲宇, 楊康明, 等. 侵犯第二、三肝門的泡型肝包蟲病行分步切除的初步經驗. 中國普外基礎與臨床雜志, 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. 王文濤, 楊闖, 嚴律南. 肝泡型包蟲病外科根治性治療的新理念與策略. 中華醫學雜志, 2018, 98(38): 3049-3051.
7. 牛祁光. 姑息性手術聯合藥物與單純口服藥物治療晚期肝泡型包蟲病的生存率的系統分析. 烏魯木齊: 新疆醫科大學, 2018.
8. 陳哲宇. 泡型肝包蟲病的外科治療現狀. 中國普外基礎與臨床雜志, 2016, 23(5): 513-516.
9. 趙順云, 阿吉德, 吳世樂, 等. 晚期肝泡型包蟲病的治療現狀及進展. 中華肝膽外科雜志, 2020, 26(3): 233-236.
10. 王文濤, 楊先偉, 嚴律南. 離體肝切除聯合自體肝移植治療晚期肝泡型包蟲病. 中國普外基礎與臨床雜志, 2017, 24(7): 792-794.
11. 阿吉德, 柴金萍, 王皓, 等. 解剖性肝切除治療肝泡型包蟲病臨床價值研究. 中國實用外科雜志, 2019, 39(12): 1331-1334.
12. 玉蘇甫卡迪爾·麥麥提尼加提. 自體肝移植治療肝泡型包蟲病的下腔靜脈重建方式的臨床研究. 烏魯木齊: 新疆醫科大學, 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. 陳克霏, 唐友銀, 賈貴清, 等. 復雜泡型肝包蟲根治性肝切除的MDT討論. 中國普外基礎與臨床雜志, 2018, 25(1): 77-82.
15. 強巴旦增, 顧炯, 侯輝. 西藏山南市肝包蟲病外科治療經驗. 肝膽外科雜志, 2019, 27(3): 225-227.
16. 李作安, 吐爾干艾力·阿吉, 冉博, 等. “減體積式病灶肝切除”治療晚期肝巨大泡型包蟲病的臨床應用. 中國普通外科雜志, 2012, 21(7): 864-868.
17. 方丹, 陳哲宇, 曾勇, 等. 泡型肝包蟲病的外科治療. 中國普外基礎與臨床雜志, 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. 趙順云, 郭亞民, 李冰. 手術聯合阿苯達唑脂質體治療晚期泡型肝包蟲病. 中華肝膽外科雜志, 2015, 21(5): 321-323.
23. 邵英梅, 蔣鐵民, 吐爾干艾力·阿吉, 等. 根治性及準根治性手術治療終末期肝泡型包蟲病. 中華消化外科雜志, 2011, 10(4): 296-298.
24. 張瀚之, 陳哲宇, 嚴律南, 等. 肝包蟲病外科治療的單中心經驗. 中國普外基礎與臨床雜志, 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, 趙順云, 等. 保留肝后下腔靜脈的離體肝切除、自體肝移植術在治療終末期肝泡型包蟲病中的臨床應用. 中華肝膽外科雜志, 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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