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