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.
Results of the Controlled Clinical Test of Intraoperative Blood Reinfusion Hardware, Assembled From the Abdominal Cavity in Conditions of Slow and Fast Modes
