Laparoscopic Treatment Strategies for Liver Echinococcosis

Wan, Li; Wang, Tao; Cheng, Long; Yu, Qianjun

doi:10.1007/s40121-022-00664-2

Cited by 7 publications

(3 citation statements)

References 37 publications

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“…However, posterior, deep or calcified cysts, and cysts located close to the inferior vena cava cannot be selected for this procedure. Specifically, the contraindications for laparoscopic surgery are patients CE5 surrounding the CE cysts difficult to separate and cysts with thickness of external capsule wall less than 3 mm [9].…”

Section: Laparoscopic Techniquementioning

confidence: 99%

New Energy Devices in the Treatment of Cystic Echinococcosis

Vangelakou¹,

Pitsilka²,

Magouliotis³

et al. 2023

Infectious Diseases

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Treatment of cystic echinococcosis of the liver still remains a debatable subject. The method of choice should aim for the total elimination of the parasite with minimum morbidity and mortality. Different approaches have been proposed. Medical treatment as a monotherapy has been abandoned due to the high chances of recurrence and is mostly used as an adjuvant to surgery or minimally invasive methods. Surgical methods are divided into conservative ones, which include cystectomy and partial pericystectomy, and radical ones, total pericystectomy and hepatectomy. Radical procedures are correlated with lower complication and recurrence rates and, therefore, should be attempted when indications are present. On the other hand, conservative surgery can be the first option in endemic areas, performed by non-specialized general surgeons. The development of laparoscopic techniques made their use a possible alternative approach in selected cases. The use of percutaneous treatments is also quite widespread due to their minimally invasive nature. New energy devices seem to play a significant role in the treatment of cystic echinococcosis, although more studies are needed to establish their efficacy. Observation without intervention is an option for inactive uncomplicated cysts.

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Section: Laparoscopic Techniquementioning

confidence: 99%

New Energy Devices in the Treatment of Cystic Echinococcosis

Vangelakou¹,

Pitsilka²,

Magouliotis³

et al. 2023

Infectious Diseases

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“…Laparoscopy has been successfully used to treat anteriorly located hepatic cysts [11]. On the other hand, adverse outcomes have been reported for treating multiple diffuse cysts, posterior cysts, deep intraparenchymal cysts, and those with adhesions to other tissues like the vena cava with a laparoscopic approach [3,10,12,13 ▪ ]. In addition, it is thought that the elevated intra-abdominal pressure required by the laparoscopic technique could increase the risk of spillage [10].…”

Section: Role Of Endoscopic Surgerymentioning

confidence: 99%

Surgical management of cystic echinococcosis of the liver

Berto,

Liou,

Coyle

et al. 2023

Current Opinion in Infectious Diseases

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Purpose of review Cystic echinococcosis is a zoonotic infection frequently involving the liver. Treatment options, including surgery, are decided based on the staging of the disease. Recent findings Ultrasound is the cornerstone for diagnosis, staging, and follow-up of cystic echinococcosis. MRI can help to evaluate for cystobiliary complications and planning of the surgery. The two main surgical approaches for cystic echinococcosis include a radical approach, which entails a partial hepatectomy and total pericystectomy, and a conservative approach or endocystectomy. Recent data suggest a conservative approach is well tolerated with acceptable morbidity and no mortality. Recurrences in centers with experience are rare. Data on laparoscopic surgery is emerging, but long-term follow-up still needs to be improved. Summary Surgical treatment options should be carefully evaluated according to the cystic echinococcosis disease staging. A multidisciplinary approach, including diagnostic and interventional radiology, abdominal and liver surgery, and infectious diseases, results in better outcomes.

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“…The cyst wall of hydatid cysts is divided into two layers: (1) the inner capsule, which has a worm structure; and (2) the outer capsule, which is a dense fibrous layer characterized by macrophage granulomatous lesions and fibrosis formed by the host upon immune rejection of the parasite[5]. At present, the treatment strategy for CE is surgical resection and drug therapy, but surgical resection can result in secondary infection and drug resistance is gradually increasing[6–9].…”

Section: Introductionmentioning

confidence: 99%

Effects of protoscoleces excretory-secretory products of Echinococcus granulosus on hepatocyte growth, function, and glucose metabolism

Luo

Lü³

et al. 2022

Preprint

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Cystic echinococcosis (CE) is one of the most widespread and harmful zoonotic parasitic diseases and it most commonly affects the liver. In this study, we characterized multiple changes in mouse hepatocytes following treatment with excretory-secretory (ES) products of Echinococcus granulosus protoscoleces by a factorial experiment. The cell counting kit-8 assay (CCK-8), the 5-ethynyl-2'-deoxyuridine (EdU) assay, and flow cytometry were used to detect the growth of hepatocytes. Inverted microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM) were used to observe the morphology and ultrastructure of hepatocytes. An automatic biochemical analyzer and an ELISA detection kit were used to determine six conventional hepatocyte enzymatic indices, the levels of five hepatocyte-synthesized substances, and the contents of glucose and lactate. Western blot analysis was conducted to analyze the protein expression of six rate-limiting enzymes in the glucose metabolism pathway in hepatocytes: glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), gamma-glutamyl transpeptidase (GGT), and leucine arylamidase (LAP). The results of the CCK-8 and EdU assays both showed that ES could inhibit the proliferation of hepatocytes, and flow cytometry indicated that ES could promote apoptosis of hepatocytes. After ES treatment, the ultrastructure of hepatocytes was disrupted to a certain extent. The changes in the cell membrane and microvilli were observed through SEM, and the changes in the nucleus, mitochondria, and rough endoplasmic reticulum were observed through TEM. After ES treatment, the enzymatic activities of the six hepatocyte enzymes were increased in addition to the Fe metabolism and the synthesis of albumin (ALB), uric acid (UA), and urea, whereas the synthesis of transferrin (TRF) was decreased. The expression levels of all six key enzymes in the glucose metabolism pathway in hepatocytes were decreased, and the biological effects were significantly inhibited. We analyzed the causes and possible complications caused by various changes and advocate corresponding measures. We also propose possible mechanisms by which protoscoleces cause hepatocyte necrosis, but the specific mechanism requires further study.

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Laparoscopic Treatment Strategies for Liver Echinococcosis

Cited by 7 publications

References 37 publications

New Energy Devices in the Treatment of Cystic Echinococcosis

New Energy Devices in the Treatment of Cystic Echinococcosis

Surgical management of cystic echinococcosis of the liver

Effects of protoscoleces excretory-secretory products of Echinococcus granulosus on hepatocyte growth, function, and glucose metabolism

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