Pattern of Relapse in Hepatic Hydatidosis: Analysis of 238 Cases in a Single Hospital

Jaén-Torrejimeno, Isabel; López-Guerra, Diego; Prada-Villaverde, Aranzazu; Blanco-Fernández, Gerardo

doi:10.1007/s11605-019-04163-7

Cited by 15 publications

(12 citation statements)

References 19 publications

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“…Análisis de regresión logística bivariada y multivariada para evaluar el riesgo de presentar complicaciones prequirúrgicas en pacientes con equinococosis quística. (12,(14)(15)(16)(17)(18)(19) , predictores de mortalidad (12) , factores de riesgo durante la cirugía (20) y factores asociados a la perforación peritoneal (21)(22) . Es crucial identificar las complicaciones prequirúrgicas, porque permitiría una hospitalización oportuna, evitando complicaciones severas que podrían empeorar el pronóstico (21) o permitiría intervenciones más seguras y apropiadas para reducir el riesgo de morir.…”

Section: Discussionunclassified

“…La edad, la localización hepática, el tamaño, la cantidad de quistes, la ruptura y la fístula biliar han sido identificados como factores o predictores de riesgo de las complicaciones o morbilidades posoperatorias (12)(13)(14)(15)(16)(17)(18)(19) . También se han investigado predictores de mortalidad (12) , factores de riesgo de complicaciones durante la cirugía (20) y asociados a la perforación peritoneal (21,22) , pero no se han realizado estudios orientados a identificar los factores de riesgo para desarrollar complicaciones prequirúrgicas.…”

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Factores asociados a complicaciones prequirúrgicas en pacientes con equinococosis quística de áreas endémicas del Perú

Pacífico

Cabrera

Salgado-Díaz

et al. 2021

Rev Peru Med Exp Salud Publica

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Objetivo: Identificar los factores asociados a complicaciones prequirúrgicas en pacientes con equinococosis quística (EC) en áreas endémicas del Perú. Materiales y métodos: Se diseñó un estudio de casos (n = 43) y controles (n = 127), sin emparejamiento, de fuente secundaria con una relación de caso-control de 1:3. Se definió como «caso» al paciente con EC que presentó complicaciones prequirúrgicas relacionadas o no con la enfermedad y el control sin complicación prequirúrgica. La variable respuesta fue complicación prequirúrgica y las de exposición fueron edad, género, grado de instrucción, ocupación, número de quistes, tamaño (diámetro en centímetros) y localización del quiste. Para identificar los factores de riesgo, primero se calcularon los odds ratio crudos (ORc) mediante regresión logística; luego las variables que mostraron asociación significativa se ajustaron mediante análisis multivariado de regresión logística utilizando Stata® versión 14, y se obtuvieron los odds ratio ajustados (ORa). Resultados: El 55,8% (24/43) de los casos fueron mujeres y la mediana de edad fue 35 años. Entre los controles, el 59,1% (75/127) fueron mujeres y la mediana de edad fue 27 años. En el análisis de regresión logística multivariado, se encontró que tener más de 56 años tiene un ORa de 2,91 (intervalo de confianza [IC] 95%: 1,01-8,43) y tener ≥3 quistes tiene un ORa de 4,26 (IC 95%: 1,62-11,22) para presentar complicaciones prequirúrgicas en pacientes con EQ. Conclusión: Los factores asociados para presentar complicaciones prequirúrgicas en EQ fueron el tener más de 56 años y el tener ≥3 quistes.

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Section: Discussionunclassified

Section: Mensajes Clave Introducciónunclassified

Factores asociados a complicaciones prequirúrgicas en pacientes con equinococosis quística de áreas endémicas del Perú

Pacífico

Cabrera

Salgado-Díaz

et al. 2021

Rev Peru Med Exp Salud Publica

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“…In our center, based on cyst type, location, size and presence/absence of complications, treatment modalities of total cystectomy, subtotal cystectomy, hepatectomy and endocystectomy were used for hepatic CE patients [31]. Based on our experience and other studies [14,24], hepatectomy may be used as a preferred treatment modality in the following situations: (a) several CE cysts were confined to one hepatic segment or hepatic lobe; (b) there were recurrent thick wall cysts accompanied by intracystic infection or granuloma formation; and (c) there was biliary fistula in the remnant cavity with long-term tube or repeated debridement without recover. When hepatic CE lesions are localized in special sites and their volume is huge, it may sometimes be risky to perform total cystectomy.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment modalities of hilar biliary duct stricture in hepatic cystic echinococcosis after endocystectomy

et al. 2021

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Aim: Hilar biliary duct stricture may occur in hepatic cystic echinococcosis (CE) patients after endocystectomy. This study aimed to explore diagnosis and treatment modalities. Methods: Clinical data of 26 hepatic CE patients undergoing endocystectomy who developed postoperative hilar biliary duct stricture were retrospectively analyzed and were classified into three types: type A, type B, and type C. Postoperative complications and survival time were successfully followed up. Results: Imaging showed biliary duct stenosis, atrophy of ipsilateral hepatic lobe, reactive hyperplasia, hepatic hilum calcification, and dilation or discontinuity of intrahepatic biliary duct. All patients received partial hepatectomy to resect residual cyst cavity and atrophic liver tissue, and anastomosis of hepatic duct with jejunum or common bile duct exploration was applied to handle hilar biliary duct stricture. Twenty-five patients were successfully followed up. Among type A patients, one patient died of organ failure, and upper gastrointestinal bleeding and liver abscess occurred in one patient. Moreover, calculus of intrahepatic duct was found in one type B and type C patient. Conclusion: Long-term biliary fistula, infection of residual cavity or obstructive jaundice in hepatic CE patients after endocystectomy are possible indicators of hilar bile duct stricture. Individualized and comprehensive treatment measures, especially effective treatment of residual cavity and biliary fistula, are optimal to avoid serious hilar bile duct stricture.

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“…Recurrence may have many reasons such as insufficient drainage, overlooked cysts, spread into the abdomen during surgery, and lack of medical treatment. Even postoperative cystic cavity collections may cause false recurrence diagnosis (4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Recurrence of Hepatic Hydatidosis: How and Why?

Tarim

Mutlu

Karabulut

et al. 2021

Middle Black Sea Journal of Health Science

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Objective: For recurrence of hepatic hydatid, cysts overlooked during surgery, secondary cysts due to the spread of cystic fluid, late postoperative hydatid cyst formation and inadequate treatment are recommended. Factors affecting recurrence were investigated in cases with recurrence. In this retrospective study, data on 199 patients with hepatic hydatid disease treated by surgery in our hospital, between January 1993 and December 2018 were reviewed.Methods: In this study, patients who were operated for hepatic hydatid disease; The relationship between cyst diameters, cyst stages, number of cysts and recurrence was investigated.Results: 84 patients were male and 115 were female. Most of the cases (189 patients- 88.06 %) treated by conservative surgical methods. Remaining’s (8 patients-4.3 %) had total cystectomy or segmental hepatectomy. Recurrence rate was found 5.47%. In that cases, primary operations were done by us, there was no significant differences between cysts’ stages and recurrences. There was not significantly differences between cysts’ number and recurrences, except the patients had 2 cysts (z=2.17, p=0.03).Conclusion: The best way of prevention of the recurrence of hepatic hydatid cysts are complete diagnosis of cysts' classification, localization, and medico-surgical combination. Perioperative medical treatment must be start three days ago before the operation and should be continued for at least 6 months.

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Pattern of Relapse in Hepatic Hydatidosis: Analysis of 238 Cases in a Single Hospital

Cited by 15 publications

References 19 publications

Factores asociados a complicaciones prequirúrgicas en pacientes con equinococosis quística de áreas endémicas del Perú

Factores asociados a complicaciones prequirúrgicas en pacientes con equinococosis quística de áreas endémicas del Perú

Diagnosis and treatment modalities of hilar biliary duct stricture in hepatic cystic echinococcosis after endocystectomy

Recurrence of Hepatic Hydatidosis: How and Why?

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