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Abulaiti Y, Kadi A, Tayier B, Tuergan T, Shalayiadang P, Abulizi A, Ahan A. Primary pelvic Echinococcus granulosus infection: A case report. World J Clin Cases 2023; 11:4084-4089. [PMID: 37388785 PMCID: PMC10303613 DOI: 10.12998/wjcc.v11.i17.4084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/18/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Primary pelvic Echinococcus granulosus infection is clinically rare. The reported cases of pelvic Echinococcus granulosus infection are considered to be secondary to cystic echinococcosis in other organs. Single Echinococcus granulosus infection is very rare.
CASE SUMMARY In this report, we presented a case of primary pelvic Echinococcus granulosus infection admitted to the First Affiliated Hospital of Xinjiang Medical University. We described the key diagnostic points and surgical treatment of this case. We also summarized the epidemiological characteristics and pathogenesis of the disease.
CONCLUSION Our case may provide clinical data for the diagnosis and treatment of primary pelvic Echinococcus granulosus infection.
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Affiliation(s)
- Yierpan Abulaiti
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Abudureyimu Kadi
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Baihetiyaer Tayier
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Talaiti Tuergan
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Paizula Shalayiadang
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Abuduaini Abulizi
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Ayifuhan Ahan
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
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Kadi A, Tuergan T, Abulaiti Y, Shalayiadang P, Tayier B, Abulizi A, Tuohuti M, Ahan A. Laparoscopic treatment of pyogenic liver abscess caused by fishbone puncture through the stomach wall and into the liver: A case report. World J Clin Cases 2022; 10:13402-13407. [PMID: 36683634 PMCID: PMC9850996 DOI: 10.12998/wjcc.v10.i36.13402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/28/2022] [Accepted: 12/05/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pyogenic liver abscess (PLA) due to foreign body penetration of the gastrointestinal tract is rare but can lead to serious consequences if not diagnosed and managed properly. We report a case of PLA caused by a fishbone puncture.
CASE SUMMARY This report describes the clinical features, diagnosis and treatment of a 56-year-old male patient who presented with severe pneumonia, acute respiratory failure and septic shock. The main clinical manifestation was a nonspecific recurrent infection. Based on the findings of abdominal computed tomography examination and the detailed medical history, the diagnosis was made as PLA which was caused by fishbone puncture through the stomach wall and into the liver. After active anti-inflammatory treatment, the patient's general condition had improved. The laparoscopic drainage of the liver abscess and the foreign body removal was performed. There was no recurrence of abscess at discharge or during follow-up and the patient’s general condition was satisfactory.
CONCLUSION PLA caused by foreign bodies usually requires surgical treatment or percutaneous drainage combined with antibiotics. Our case confirms that a laparoscopic approach is safe and feasible for such cases.
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Affiliation(s)
- Abudureyimu Kadi
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Talaiti Tuergan
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Yierpan Abulaiti
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Paizula Shalayiadang
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Baihetiyaer Tayier
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Abududuaini Abulizi
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Muniremu Tuohuti
- Department of General Medicine, First People's Hospital of Aksu Region, Aksu 843099, Xinjiang Uygur Autonomous Region, China
| | - Ayifuhan Ahan
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
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Guo Q, Wang M, Zhong K, Li J, Jiang T, Ran B, Shalayiadang P, Zhang R, Tuergan T, Aji T, Shao Y. Application of hepatic lobe hyperplasia techniques in the treatment of advanced hepatic alveolar echinococcosis: a single-centre experience. BMC Surg 2022; 22:415. [PMID: 36474286 PMCID: PMC9724394 DOI: 10.1186/s12893-022-01864-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study was designed to investigate clinical efficiency and application indications of hepatic lobe hyperplasia techniques for advanced hepatic alveolar echinococcosis (AE) patients. METHODS A retrospective case series covering 19 advanced hepatic AE patients admitted to the First Affiliated Hospital of Xinjiang Medical University from September 2014 to December 2021 and undergoing hepatic lobe hyperplasia techniques due to insufficient remnant liver volume were analyzed. Changes of liver function, lesions volume, remnant liver volume, total liver volume before and after operation have been observed. RESULTS Among the patients, 15 underwent portal vein embolization (PVE). There was no statistical difference in total liver volume and lesions volume before and after PVE (P > 0.05). However, the remnant liver volume was significantly increased after PVE (P < 0.05). The median monthly increase rate in future liver remnant volume (FLRV) after PVE stood at 4.49% (IQR 3.55-7.06). Among the four patients undergoing two-stage hepatectomy (TSH), FLRV was larger than that before the first stage surgery, and the median monthly increase rate in FLRV after it stood at 3.34% (IQR 2.17-4.61). Despite no statistical difference in total bilirubin (TBil), albumin (Alb), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT) in all patients with PVE, four patients who underwent TSH showed a decrease in ALT, AST and GGT. During the waiting process before the second stage operation, no serious complications occurred in all patients. CONCLUSIONS For patients suffering from advanced hepatic AE with insufficient FLRV, PVE and TSH are safe and feasible in promoting hepatic lobe hyperplasia.
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Affiliation(s)
- Qiang Guo
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Maolin Wang
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Kai Zhong
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Jialong Li
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Tiemin Jiang
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Bo Ran
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Paizula Shalayiadang
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Ruiqing Zhang
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Talaiti Tuergan
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Tuerganaili Aji
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
| | - Yingmei Shao
- grid.412631.3Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 Xinjiang China ,Clinical Medical Research Center of Echinococcosis and Hepatobiliary Disease of Xinjiang Uygur Autonomous Region, Urumqi, 830054 Xinjiang China
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Shalayiadang P, Yasen A, Abulizi A, Ahan A, Jiang T, Ran B, Zhang R, Guo Q, Wen H, Shao Y, Aji T. Long-term postoperative outcomes of Roux-en-Y cholangiojejunostomy in patients with benign biliary stricture. BMC Surg 2022; 22:231. [PMID: 35710403 PMCID: PMC9204910 DOI: 10.1186/s12893-022-01622-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although there are common postoperative complications, Roux-en-Y cholangiojejunostomy is still broadly used as a standard surgical procedure for patients with biliary stricture. This study aimed to explore long-term risk factors of cholangiojejunostomy in patients with biliary stricture who underwent revisional cholangiojejunostomy. Methods Clinical data of 61 patients with biliary stricture undergoing revisional cholangiojejunostomy were retrospectively analyzed. These patients were classified into two groups (patients with traumatic biliary stricture and non-traumatic biliary stricture). Postoperative complications and survival time were successfully followed up. Results Among the patients, 34 underwent revisional cholangiojejunostomy due to traumatic biliary stricture, and 27 underwent revisional cholangiojejunostomy due to non-traumatic biliary surgery. Although there was no statistical difference in most clinical data between two groups, biliary dilation or not during the first surgery, cholelithiasis or not during the first surgery, long-term complications after first surgery, cholelithiasis or not during the second surgery, identifying abnormalities during the second surgery and long-term complications after second surgery were significantly different. All patients were successfully followed up and average follow-up time for patients with traumatic and non-traumatic biliary stricture was (88.44 ± 35.67) months and (69.48 ± 36.61) months respectively. Survival analysis indicated that there was no statistical difference in overall survival between two groups. Additionally, cox proportional hazard analysis demonstrated that first preoperative bilirubin level, short-term complication after first surgery and identifying abnormalities during the second surgery were independent risk factors that may have significant effects on patients' overall survival and long-term prognosis after cholangiojejunostomy. Among the intraoperative abnormal findings, residual lesions after the first operation had significant effects on the patients overall survival in the earlier stage. Relatively, anastomotic stoma stricture and biliary output loop problems had obvious effects on patients' overall survival at later stages. Conclusion First preoperative bilirubin level, short-term complication after first surgery and abnormal findings during the second surgery were independent risk factors of revisional cholangiojejunostomy, which may affect patients' long-term survival. Therefore, surgeons should minimize incidence of postoperative complications through fully evaluating optimal operative time and standardizing surgical procedures.
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Affiliation(s)
- Paizula Shalayiadang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Aimaiti Yasen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Abduaini Abulizi
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Ayifuhan Ahan
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Tiemin Jiang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Bo Ran
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Ruiqing Zhang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Qiang Guo
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Hao Wen
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China.,State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Yingmei Shao
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Tuerganaili Aji
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China.
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Shalayiadang P, Abulizi A, Ahan A, Jiang T, Ran B, Zhang R, Guo Q, Wen H, Shao Y, Aji T. Diagnosis and treatment modalities of hilar biliary duct stricture in hepatic cystic echinococcosis after endocystectomy. ACTA ACUST UNITED AC 2021; 28:51. [PMID: 34142953 PMCID: PMC8212812 DOI: 10.1051/parasite/2021051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/01/2021] [Indexed: 11/20/2022]
Abstract
Aim: Hilar biliary duct stricture may occur in hepatic cystic echinococcosis (CE) patients after endocystectomy. This study aimed to explore diagnosis and treatment modalities. Methods: Clinical data of 26 hepatic CE patients undergoing endocystectomy who developed postoperative hilar biliary duct stricture were retrospectively analyzed and were classified into three types: type A, type B, and type C. Postoperative complications and survival time were successfully followed up. Results: Imaging showed biliary duct stenosis, atrophy of ipsilateral hepatic lobe, reactive hyperplasia, hepatic hilum calcification, and dilation or discontinuity of intrahepatic biliary duct. All patients received partial hepatectomy to resect residual cyst cavity and atrophic liver tissue, and anastomosis of hepatic duct with jejunum or common bile duct exploration was applied to handle hilar biliary duct stricture. Twenty-five patients were successfully followed up. Among type A patients, one patient died of organ failure, and upper gastrointestinal bleeding and liver abscess occurred in one patient. Moreover, calculus of intrahepatic duct was found in one type B and type C patient. Conclusion: Long-term biliary fistula, infection of residual cavity or obstructive jaundice in hepatic CE patients after endocystectomy are possible indicators of hilar bile duct stricture. Individualized and comprehensive treatment measures, especially effective treatment of residual cavity and biliary fistula, are optimal to avoid serious hilar bile duct stricture.
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Affiliation(s)
- Paizula Shalayiadang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Abduaini Abulizi
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Ayifuhan Ahan
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Tiemin Jiang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Bo Ran
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Ruiqing Zhang
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Qiang Guo
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Hao Wen
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China - State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Yingmei Shao
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
| | - Tuerganaili Aji
- Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, PR China
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Wan L, Ran B, Aji T, Shalayiadang P, Jiang T, Shao Y, Wen H. Laparoscopic hepatectomy for the treatment of hepatic alveolar echinococcosis. ACTA ACUST UNITED AC 2021; 28:5. [PMID: 33439119 PMCID: PMC7805388 DOI: 10.1051/parasite/2021001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022]
Abstract
Background: At present, laparoscopy is relatively mature as a minimally invasive technique, but there are few reports on this approach for the radical treatment of hepatic alveolar echinococcosis (AE). In this study, we aimed to evaluate the safety and feasibility of laparoscopic hepatectomy (LH) for AE treatment. Results: A retrospective review of medical records obtained from 13 patients diagnosed with AE between January 2018 and December 2019 and treated with laparoscopic hepatectomy was conducted at the First Affiliated Hospital of Xinjiang Medical University. All patients (n = 13) underwent hepatic resection using laparoscopy and none were transferred to open surgery. The average duration of surgery was 285 min (145–580 min). Intraoperative bleeding was 305 mL (20–2000 mL). The mean duration of postoperative catheterization was 6.9 days (3–21 days), and postoperative hospital stay was 7.2 days (4–14 days). No complication of Clavien-Dindo grade III or above occurred, except for the second patient with acute liver failure post-surgically. No recurrences or deaths were observed at 9–30 months of follow-up. Conclusions: Laparoscopic hepatectomy appears to be safe and effective in selected AE patients. The advantages of this technique for AE treatment need to be further compared with the classical open approach.
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Affiliation(s)
- Li Wan
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, 830011 Urumqi, PR China
| | - Bo Ran
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - Xinjiang Hydatid & Hepatobiliary Surgery Medical Centre, 830054 Urumqi, PR China
| | - Tuerganaili Aji
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - Xinjiang Hydatid & Hepatobiliary Surgery Medical Centre, 830054 Urumqi, PR China
| | - Paizula Shalayiadang
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - Xinjiang Hydatid & Hepatobiliary Surgery Medical Centre, 830054 Urumqi, PR China
| | - Tiemin Jiang
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - Xinjiang Hydatid & Hepatobiliary Surgery Medical Centre, 830054 Urumqi, PR China
| | - Yingmei Shao
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - Xinjiang Hydatid & Hepatobiliary Surgery Medical Centre, 830054 Urumqi, PR China
| | - Hao Wen
- Department of Hepatobiliary & Hydatid, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, PR China - State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, 830011 Urumqi, PR China
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Shalayiadang P, Jiang T, Yimiti Y, Ran B, Aini A, Zhang R, Guo Q, Ahan A, Abulizi A, Wen H, Shao Y, Aji T. Double versus single T-tube drainage for frank cysto-biliary communication in patients with hepatic cystic echinococcosis: a retrospective cohort study with median 11 years follow-up. BMC Surg 2021; 21:12. [PMID: 33407348 PMCID: PMC7789643 DOI: 10.1186/s12893-020-01028-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Partial peri-cystectomy (PPC) is one of the major surgical approaches for hepatic cystic echinococcosis (CE) and has been practiced in most centers worldwide. Cysto-biliary communication (fistula, leakage, rupture) is a problematic issue in CE patients. T-tube is a useful technique in situations where an exploration and decompression are needed for common bile duct (CBD). However, postoperative biliary complications for cystic cavity still remains to be studied in depth. METHODS A retrospective cohort analysis of CE cases in our single center database from 2007 March to 2012 December was performed. Patients (n = 51) were divided into two cohorts: double T-tube drainage (one at CBD for decompression and one at the fistula for sustaining in cystic cavity, n = 23) group and single T-tube drainage cohort (only one at CBD for decompression, n = 28). Short-/long-term postoperative complications focusing on biliary system was recorded in detail and they were followed-up for median 11 years. RESULTS Overall biliary complication rates for double and single T-tube drainages were 17.4% vs. 39.3% (P > 0.05). Short-term complications ranged from minor to major leakages, cavity infection and abscess formation, and prevalence was 17.4% vs. 21.4% (P > 0.05) respectively for double and single T-tube groups; most importantly, double T-tube drainage group had obvious advantages regarding long-term complications (P < 0.05), which was biliary stricture needing surgery and it was observed only in single T-tube drainage group. CONCLUSIONS Double T-tube drainage had better outcomes without procedure-specific postoperative biliary complications than single T-tube drainage. Meanwhile, we recommend long-term follow-up when comparing residual cavity related biliary complications in CE patients as it could happen lately.
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Affiliation(s)
- Paizula Shalayiadang
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tiemin Jiang
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yusufu Yimiti
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Bo Ran
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Abudusalamu Aini
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ruiqing Zhang
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qiang Guo
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ayifuhan Ahan
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Abuduaini Abulizi
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, China.,WHO Collaboration Center on Prevention and Management of Echinococcosis, Clinical Medical Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yingmei Shao
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China.,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tuerganaili Aji
- Hepatobiliary and Echinococcosis Surgery Department, Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, #137 South Liyushan Road, Urumqi, 830054, China. .,Xinjiang Uyghur Autonomous Region Clinical Research Center for Echinococcosis and Hepatobiliary Diseases, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. .,Digestive and Vascular Surgery Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
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