science-review.ru
Scientific journal
Научное обозрение. Медицинские науки
ISSN 2500-0780
ПИ №ФС77-57452
ISSN 2500-0780
ПИ №ФС77-57452
TREATMENT OF HYDATID DISEASE AFFECTING THE SUPERIOR SURFACE OF LIVER
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The research is based on surgical treatment of patients suffering from liver hydatid disease (LHD) with cysts in segments 7 and 8. The key stages of hydatidectonomy (HE) are prevention of disease recurrence and removal of residual cavity. The successful outcome depends on an appropriate approach. Thoraco-phreno-laparotomia makes the task easier for a surgeon, reduces the risk of post-surgical complications and improves long-term results. The recurrence of LHD is caused by undiagnosed hydatid cysts, remaining tapeworm eggs in fibrous capsule and their seeding in abdominal cavity. The first preventive measure of disease recurrence is anti-tapeworm treatment of a cyst cavity. A fibrous capsule was treated with 90-100% glycerol, 3% hydrogen dioxide. The following stage of the operation that makes the early post-surgical period more favourable is diagnosis and removal of cystobiliary fistulas (CBF). In the case of CBF with segmental and smaller ducts involved removal was performed with plasmic coagulation of a fistula opening and suture with atraumatic sutural material. Provided that a patient suffers from the noncomplicated disease, removal of a residual cavity was performed by means of resection of a free fibrous capsule and putting the remaining part into the sanitated cavity. In some cases residual cavities were removed with the use of capitonnage procedure; if there were CBF, a micro-irrigator was left in the residual cavity for 2-3 days. Closed and semi-closed hydatidectonomy in LHD in segments 7and 8 is still the most common operation. In these cases thoraco-phreno-lumbotomic access provides careful treatment of the cyst cavity and removes CBF. The procedure reduces the frequency of post-surgical complications and improves long-term results.