Surgical treatment of hepatic alveococcosis in highly specialized centre of non-endemic region

Keywords: hepatic alveococcosis; hepatic resection.

Abstract

Objective. To estimate the results of operative treatment of hepatic alveococcosis in conditions of surgical centre of non-endemic region.

Materials and methods. From 2004 to 2020 yr in Department of Transplantation and Hepatic Surgery of Shalimov National Institute of Surgery and Transplantation NAMS of Ukraine 13 patients, suffering hepatic alveococcosis, were radically operated. General characteristic of patients, methods of preoperative preparation, іntraoperative data, the indices of morbidity and lethality were investigated.

Results. In 11 (84.6%) patients the disease was diagnosed on late stages: IIIa-IV in accordance to pTNM by WHO classification. Preoperatively in 5 (38.5%) patients transcutaneous transhepatic cholangiostomy and in 8 (615%) patients - roentgenendovascular occlusion of the portal hepatic vein branches - were performed. In 12 (92.3%) patients extended hepatic resections were done, including in 2 (15.3%) - complete vascular hepatic exclusion with hyperthermic perfusion in situ. Postoperative complications rate of IIIa-IV degrees in accordance to Clavien-Dindo classification have constituted 30.7%, while postoperative mortality - 7.7%. Up to the end of follow-up the disease-free period have persisted in all the patients.

Conclusion. Aggressive surgical tactics in patients, suffering hepatic alveococcosis, permits to obtain good immediate results in highly specialized centres. Today radical operative intervention continues to be the only one method of treatment in the patients, which may guarantee satisfactory late follow-up results.

Author Biographies

O. V. Hrynenko, Shalimov National Institute of Surgery and Transplantology NAMS of Ukraine, Kyiv

Hrynenko Oleksander V., MD, Surgeon,
Chief of Department of liver transplantation and surgery
Shalimov National Institute of Surgery and Transplantation
30 Heroiv Sevastopolya Str., 03680, Kyiv, Ukraine,
+38 (044)4542079
grinenkoalex@gmail.com
https://orcid.org/0000-0003-3535-8232

O. O. Popov, Shalimov National Institute of Surgery and Transplantology NAMS of Ukraine, Kyiv

Popov Oleksii O., MD, Surgeon,
Department of liver transplantation and surgery
Shalimov National Institute of Surgery and Transplantation
30 Heroiv Sevastopolya Str., 03680, Kyiv, Ukraine,
+38 (044)4542079
+38 (044)4542079
popovalexey78@gmail.com
https://orcid.org/0000-0003-3333-8473

A. І. Zhylenko, Shalimov National Institute of Surgery and Transplantology NAMS of Ukraine, Kyiv

Zhylenko Andrii I., MD, Surgeon,
Department of liver transplantation and surgery
Shalimov National Institute of Surgery and Transplantation
30 Heroiv Sevastopolya Str., 03680, Kyiv, Ukraine,
+38 (044)4542079
+38 (044)4542079
jojo09512@gmail.com

A. V. Husiev, Shalimov National Institute of Surgery and Transplantology NAMS of Ukraine, Kyiv

Husiev Andrii V. MD, PhD (Med),
Senior Scientific Researcher of Department of liver transplantation and surgery
Shalimov National Institute of Surgery and Transplantation
30 Heroiv Sevastopolya Str., 03680, Kyiv, Ukraine,
+38 (044)4542079
andreigusev777@gmail.com
https://orcid.org/0000-0002-9181-2578

References

Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, et al. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. Adv Parasitol. 2017;96:259-369. doi: 10.1016/bs.apar.2016.09.006. Epub 2017 Feb 8. PMID: 28212790.

Du C, Liu Z, Yang X, Yan L, Li B, Wen T, et al. Hepatectomy for patients with alveolar echinococcosis: Long-term follow-up observations of 144 cases. Int J Surg. 2016 Nov;35:147-52. doi: 10.1016/j.ijsu.2016.09.094. Epub 2016 Sep 30. PMID: 27693514.

Yang X, Qiu Y, Huang B, Wang W, Shen S, Feng X, et al. Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases. Am J Transplant. 2018 Jul;18(7):1668-79. doi: 10.1111/ajt.14621. Epub 2018 Jan 21. PMID: 29232038; PMCID: PMC6055796.

McManus DP, Gray DJ, Zhang W, Yang Y. Diagnosis, treatment, and management of echinococcosis. BMJ. 2012 Jun 11;344:e3866. doi: 10.1136/bmj.e3866. PMID: 22689886.

Qu B, Guo L, Sheng G, Yu F, Chen G, Wang Y, et al. Management of Advanced Hepatic Alveolar Echinococcosis: Report of 42 Cases. Am J Trop Med Hyg. 2017 Mar;96(3):680-5. doi: 10.4269/ajtmh.16-0557. Epub 2017 Apr 6. PMID: 28070011; PMCID: PMC5361545.

Gottstein B, Stojkovic M, Vuitton DA, Millon L, Marcinkute A, Deplazes P. Threat of alveolar echinococcosis to public health- a challenge for Europe. Trends Parasitol. 2015 Sep;31(9):407-12. doi: 10.1016/j.pt.2015.06.001. Epub 2015 Jun 23. PMID: 26115902.

Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010 Apr;114(1):1-16. doi: 10.1016/j.actatropica.2009.11.001. Epub 2009 Nov 30. PMID: 19931502.

Spahn S, Helmchen B, Zingg U. Alveolar echinococcosis of the right adrenal gland: a case report and review of the literature. J Med Case Rep. 2016 Nov 15;10(1):325. doi: 10.1186/s13256-016-1115-0. PMID: 27846915; PMCID: PMC5111185.

Chen KF, Tang YY, Wang R, Fang D, Chen JH, Zeng Y, et al. The choose of different surgical therapies of hepatic alveolar echinococcosis: A single-center retrospective case-control study. Medicine (Baltimore). 2018 Feb;97(8):e0033. doi: 10.1097/MD.0000000000010033. PMID: 29465544; PMCID: PMC5841995.

Published
2020-12-28
How to Cite
Hrynenko, O. V., Popov, O. O., ZhylenkoA. І., Husiev, A. V., & PodlyukY. І. (2020). Surgical treatment of hepatic alveococcosis in highly specialized centre of non-endemic region. Klinicheskaia Khirurgiia, 87(11-12), 28-33. https://doi.org/10.26779/2522-1396.2020.11-12.28
Section
General Problems of Surgery