TY - JOUR AU - V. A. Shaprinsky AU - O. O. Vorovsky AU - О. О. Kamins’kyy AU - A. V. Verba AU - A. M. Formanchuk AU - Yu. A. Mironishen AU - A. I. Chernichenko PY - 2021/03/20 Y2 - 2024/03/28 TI - LIVER ECHINOCOCCOSIS: DIAGNOSIS AND SURGICAL TREATMENT EXPERIENCE JF - Kharkiv Surgical School JA - Khark. Surg. Sch. VL - 0 IS - 1 SE - QUESTIONS OF SURGERY OF PANCREATOBILIARY SYSTEM DO - 10.37699/2308-7005.1.2021.12 UR - https://surgical-school.com.ua/index.php/journal/article/view/189 AB - Summary. The purpose: to analyze the results of treatment of patients with liver echinococcosis.Materials and methods: results of treatment of 76 patients with echinococcosis of the liver were analyzed, women — 66 (86,8 %), men — 10 (13,2 %). Primary echinococcosis was detected in 73 (96,1 %) patients, secondary — in 3 (3,9 %). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 66 (86,8 %) patients, multiple — in 10 (13,2 %). Among patients with solitary cysts, the right lobe was more often affected in 56 (73,7 %) patients than the left — 20 (26,3 %) cases. Echinococcosis complications were observed in 16 (21,1 %) patients. Among them, most often there were suppurations of the cyst — in 13 (17,1 %); a break of the cyst in the free abdominal cavity — in 1 (1,3 %), in the pleural cavity — 1 (1,3 %), in the biliary tract — in 1 (1,3 %). In 20 (26,3 %) cases, the operation was performed from the upper median access, in 46 (60,5%) — from oblique hypochondriac accesses by Kocher or by Fedorov. Pericystectomy was performed in 52 (68,4 %) patients, in 8 (10,5 %) patients had resections of liver segments with an echinococcal cyst, in 4 (5,3 %) — cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (15,8 %) patients. In the postoperative period, complications were observed in 16 (21,1 %) patients. The use of the welding electrocoagulator EK-300M «Swarmed» in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from (2200 ± 210) to (250 ± 50) ml, recurrences – with 2,8 up to 0 %. Before and after operation was performed antireсedive antiparasitic therapy with albendazole (Vormil) in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was prescribed at a rate of 15 mg/kg/day.Results. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0,0001); duration of operation — 2 times (р>0,05), stay in hospital - 3,3 times (р=0,002). There were no fatal outcomes.Conclusions. Pericystectomy is an effective operation for complete recovery and does not give recurrence of the disease. The use of a welding electrocoagulator and laparoscopic echinococectomy significantly improve the results of treatment of patients with parasitic liver cysts. ER -