Surgical treatment of liver alveococcosis

Abstract

Aim. To improve the results of diagnosis and surgical treatment of liver alveococcosis.Material and methods. There were 415 patients with liver alveococcosis for the period 2009–2018. Liver resection was performed in 364 patients. Metastases in the brain were detected in 7 patients, lungs – in 3 cases, soft tissues involvement – in another 3 ones. Hepatic-bronchial fistula occurred in 2 cases. Mean age of patients was 41 ± 2.3 years. There were 128 (30.8%) men and 287 (69.2%) women.Results. Advanced liver resection was performed in 187 patients, atypical resection – in 177 cases. R0-resection was carried out in 62.4% of cases, R1–2 procedures – in 37.6%, diagnostic laparotomy – in 4.4%. Four patients died in early postoperative period.Conclusion. The final decision about resectability may be made after intraoperative assessment, intraoperative ultrasound, Doppler sonography and liver mobilization. Liver resection for advanced alveococcosis is extensive, needs for resection and replacement of great vessels, as well as bile ducts repair. Radical treatment is R0-resection if distant metastases are absent. Redo surgery is advisable for liver alveococcosis.