MINIMALLY INVASIVE SURGERY FOR THE LIVER ECHINOCOCCOSIS

Abstract

Objective: Improving the results of treatment of patients with liver echinococcosis by using minimally invasive technology Methods: The results of the examination and treatment of 23 patients with liver echinococcosis are presented. There were 15 women (65%), and 8 men (35%) aged from 24 to 83 years. Depending on the peculiarities of the clinical situation, 2 options for surgical treatment were used: 1) puncturing and drainage of the cystic cavity under ultrasound control; 2) opening and processing of the cystic cavity using laparoscopic techniques Results: Laparoscopic echinococcectomy was performed in 13 (56%) patients, puncture and drainage of the echinococcus cyst under ultrasound control – 10 (44%) patients. The postoperative period was much easier after minimally invasive interventions for liver echinococcosis. Cystobiliary fistulae were observed in 3 cases, which required additional transfistula medical interventions. In 2 more cases after puncture-draining interventions under ultrasound control, the suppurations of the residual cavity are marked with the increase of the next day of its size in comparison with the initial that has demanded re-drainage. Conclusion: Minimally invasive methods of echinococcectomy using laparoscopic techniques and the transcutaneous removal of an echinococcal cyst under ultrasound control are low-traumatic procedures and can be an alternative to open surgical interventions. This helps to reduce the frequency of postoperative complications, especially in persons of the elderly and old ages with concomitant diseases.

Keywords

• liver echinococcosis
• minimally invasive technologies
• laparoscopy
• percutaneous removal
• cystic cavity
• transfistula interventions.