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Treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture by pericystectomy in combination with Roux-en-Y hepaticojejunostomy

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单位: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Ctr Hepat Surg, Wuhan 430030, Peoples R China [2]Shihezi Univ, Coll Med, Affiliated Hosp 1, Dept Hepatobiliary Surg, Shihezi 832000, Peoples R China [3]Huazhong Univ Sci & Technol, Tongji Med Coll, Sch Publ Hlth, Dept Social Med, Wuhan 430030, Peoples R China [4]Shihezi Univ, Coll Med, Dept Prevent Med, Shihezi 832000, Peoples R China
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关键词: hepatic cystic hydatidosis intrabiliary rupture pericystectomy hepaticojejunostomy

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This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78 +/- 7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33 +/- 1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79 +/- 0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.

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出版当年[2011]版:
大类 | 4 区 医学
小类 | 4 区 生化与分子生物学
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Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY
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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Ctr Hepat Surg, Wuhan 430030, Peoples R China [2]Shihezi Univ, Coll Med, Affiliated Hosp 1, Dept Hepatobiliary Surg, Shihezi 832000, Peoples R China
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