Percutaneous echinococcectomy from the liver

Abstract

Background: Hepatic alveococcosis is extremely aggressive disease. Methods: We examined 41 patients from [2008][2009][2010][2011][2012][2013][2014][2015][2016][2017]36 were operated:31 hepatic resections, 4 liver transplantation(OLT), 1 portosystemic shunting.Among all the cases of hepatic resections (n=1067) alveococcosis accounts for 3.28% Extrahepatic alveococcosis 2(lungs). The complications:9 obstructive jaundice, 4 portal hypertension, 1 viral hepatic cirrhosis. The size of a parasitic node in the liver varied 9.3-21.7cm. Results: 35 radical operated:31 R0-resections,4 OLT,1 portosystemic shunting. 6 were not operated:2 due to marked comorbidity;2 chronic infection+biliary fistulas;1 bile ducts stenting,1 suggested transplantation.Among the surgeries:4 right hepatectomy,16 right extensive hepatectomy,2 left extensive hepatectomy,1 left hepatectomy,1 hepatectomy with reverse autotransplantation of the left lateral segment,1 left hepatectomy "ex situ" with 1 and 8 segmentectomy,1 three-segmentectomy,3 bisegmentectomy,2 segmentectomy. 14 patients have IVC ingrowth:9 IVC prosthetic:4 one-stage left hepatic vein plastic,5eIVC resection.13 portal vein resection,7 resection of extrahepatic ducts,7 resection of diaphragm. 11 cases of bile leakage(ISGLS):grade Be4, Сe7. Postoperative complications-16(Clavien-Dindo):typeIIe4,IVbe1,IIIbe8,Ve3. The long-term results:1 recurrent case,2 fatal cases. Conclusion: Liver resection is a treatment of choice,characterized by large extent of resection,and accompanied by resection plastic operations on major vessels and bile ducts