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, 伍衛平, 朱雪花. 2004-2008年全國包蟲病疫情分析. 中國人獸共患病學報, 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.	張朝陽. 肝泡型棘球蚴病的治療進展. 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.	何偉, 尚婧曄, 黃燕, 等. 2007-2013年四川省包蟲病疫情監測結果分析. 預防醫學情報雜志, 2016, 32(8): 798-800.
6.	喻文杰, 王謙, 廖沙, 等. 2017年四川省石渠縣包蟲病患病情況現狀調查. 預防醫學情報雜志, 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.
9.	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.
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.	溫浩, 邵英梅, 趙晉明, 等. 兩型肝包蟲病手術療效547例臨床分析. 中華消化外科雜志, 2007, 6(1): 13-18.
12.	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.
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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.	四川省包蟲病臨床醫學研究中心, 四川省醫師協會包蟲病專業委員會. 泡型肝包蟲病診療專家共識 (2020版). 中國普外基礎與臨床雜志, 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.
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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.	王瑞濤, 劉昌, 張曉剛, 等. ALPPS在肝泡型包蟲病中的應用. 中華肝臟外科手術學電子雜志, 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.
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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.	姚秉禮. 肝泡狀棘球蚴的診斷和治療. 中華外科雜志, 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.
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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.
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1. 王立英, 伍衛平, 朱雪花. 2004-2008年全國包蟲病疫情分析. 中國人獸共患病學報, 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. 張朝陽. 肝泡型棘球蚴病的治療進展. 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. 何偉, 尚婧曄, 黃燕, 等. 2007-2013年四川省包蟲病疫情監測結果分析. 預防醫學情報雜志, 2016, 32(8): 798-800.
6. 喻文杰, 王謙, 廖沙, 等. 2017年四川省石渠縣包蟲病患病情況現狀調查. 預防醫學情報雜志, 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.
9. 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.
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. 溫浩, 邵英梅, 趙晉明, 等. 兩型肝包蟲病手術療效547例臨床分析. 中華消化外科雜志, 2007, 6(1): 13-18.
12. 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.
13. 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.
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. 四川省包蟲病臨床醫學研究中心, 四川省醫師協會包蟲病專業委員會. 泡型肝包蟲病診療專家共識 (2020版). 中國普外基礎與臨床雜志, 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. 四川省包蟲病臨床醫學研究中心, 四川省醫師協會包蟲病專業委員會. 復雜肝泡型包蟲病診療專家共識 (2020版). 中國普外基礎與臨床雜志, 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. 王瑞濤, 劉昌, 張曉剛, 等. ALPPS在肝泡型包蟲病中的應用. 中華肝臟外科手術學電子雜志, 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. 姚秉禮. 肝泡狀棘球蚴的診斷和治療. 中華外科雜志, 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, 胡濤, 鄧勇, 等. 經內鏡逆行胰膽管造影治療泡型肝包蟲病合并梗阻性黃疸的有效性分析. 中華消化內鏡雜志, 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.
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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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