During the years 1936 through 1978, 60 cases received surgical intervention for alveolar echinococcosis of the liver. The resectability and operative mortality rate were 64.0% (16/25) and 43.8% (7/16) before 1968, but 54.3% (19/35) and zero (0/19) thereafter. Establishment of clinical staging and criteria for justifying radical resection of a given lesion, combined with systematic evaluation of all hepatic vasculatures, contributed to improvement of the result. The long-term prognosis of the disease, unless resected, has been exclusively poor. A mass screening program, which became possible by the development of serologic tests, has covered a population of over 140,000 in the endemic area and been of value in detecting the disease in its early developmental stage. The disease should be recognized even in currently unaffected areas since the cestode has a fairly wide geographic distribution including the United States.
Guest Editor's Introduction: This paper was originally presented at the 9th congress of ASAIO in April 1963. The original paper was printed in Volume IX of Trans. Soc. Artif. Int. Organs 1963, pages 358–362. It was reprinted with permission in Therapeutic Apheresis, Volume 4, Issue 1, 2000 as a millennium project of the International Society for Apheresis. This paper describes for the first time a hybrid artificial live and extracorporeal circulatory system composed of a specially developed high permeable gel type cellophane membrane. This membrane separated the patient's blood and the metabolic fluid in which freeze‐dried canine liver granules were contained. Carbohydrate metabolism and ammonia detoxification were maintained in this metabolic chamber, eventually helping the patient's metabolic functions. In addition to experimental studies, four clinical studies were briefly reported.
A generally recognized concept dictates that surgical intervention for non-parasitic cysts of the liver is mostly palliative such as aspiration of the content, suture and closure, internal or external drainage, marsupialization, and unroofing of the cyst, while total excision of the entire cyst, which sometimes necessitates hepatic resection, is not usually recommended.3, 6, 9 The results of these lesser procedures have been acceptable, favoring those conservative procedures. This paper presents three cases with carcinoma arising in the cysts of the liver. Review of the present cases with five comparable cases appearing in the literature revealed that young female population and left lobe of the liver are frequently involved. Hence the general trend for palliative procedures should be reassessed. Possible malignancy should be considered when a patient belongs to this category, the cystic content is not clear, or the cystic wall presents irregular texture with nodules. The carcinomatous changes would have been of higher incidence than reported if the entire cysts had been more carefully examined.
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