Control Study of Clinical Effect of the Surgery with Laparoscope and Choledochoscope on Plateau Hepatic Hydatid Biloary Fistulas_West China Medical Journal

Authors：

 DANGBao-bao , QINWei ,  DONGJin , CHUXiao-mei

Department of Laparoscopic Surgery, Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, P. R. China;

Corresponding author：

DONGJin, Email: qhdongjin@163.com

Keywords：

Laparoscopy; Choledochoscope; Liver hydatid disease; Biliary fi stula

DOI：

10.7507/1002-0179.20140381

Video：

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Objective To explore the effect of the surgery with laparoscope combined with choledochoscope on plateau hepatic hydatid biliary fistulas. Methods A total of 100 patients with liver hydatid disease diagnosed between January 2012 and June 2013 were divided into two groups according to the admitting time:laparoscope combined with choledochoscope group (combined group) and laparoscope group, with 50 patients in each group. The therapeutic results of the two groups were compared. Results A total of 186 biliary fistulas were found in the combined group during the operation, and there were 5 patients with biliary fistulas after the surgery; while 87 biliary fistulas were found in laparoscope group during the operation and there were 16 patients with biliary fistulas after the surgery. The difference in the occurrence rate of biliary fistulas after surgery between the two groups was significant (χ²=7.294, P=0.007). No infection of incisional wound was found in combined group but 5 infection was found in laparoscope group. The postoperative extubation time in the combined group and laparoscope group was (10.35±3.87) and (27.16±4.58) days, respectively, with a significant difference (t=12.538, P<0.001). Conclusion The laparoscope combined with choledochoscope is a minimally invasive and safe therapeutic option for plateau hepatic hydatid biliary fistulas.

Citation： DANGBao-bao, QINWei, DONGJin, CHUXiao-mei. Control Study of Clinical Effect of the Surgery with Laparoscope and Choledochoscope on Plateau Hepatic Hydatid Biloary Fistulas. West China Medical Journal, 2014, 29(7): 1238-1241. doi: 10.7507/1002-0179.20140381 Copy

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13.	Cugat E, Olsina JJ, Rotellar F, et al. Initial results of the National Registry of Laparoscopic Liver Surgery[J]. Cirugía Española, 2005, 78(3):152-160.
14.	Yagci G, Ustunsoz B, Kaymakcioglu N, et al. Results of surgical,laparoscopic, and percutaneous treatment for hydatid disease of the liver:10 years experience with 355 patients[J]. World J Surg, 2005, 29(12):1670-1679.
15.	Ben Brahim M, Nouri A, Ksia A, et al. Management of multiple echinococcosis in childhood with albendazole and surgery[J]. J Pediatr Surg, 2008, 43(11):2024-2030.
16.	Chen W, Xusheng L. Laparoscopic surgical techniques in patients with hepatic hydatid cyst[J]. Am J Surg, 2007, 194(2):243-247.
17.	Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cysti cliver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
18.	廖霄斌, 赵晋明, 李介秋, 等. 腹腔镜肝包虫外囊剥离联合胆囊切除1例[J]. 中国普通外科杂志, 2009, 9(9):931-932.
19.	李荣梓, 柴福录, 肖毅, 等. 腹腔镜技术在肝包虫病治疗中的应用. 腹腔镜外科杂志[J]. 2009, 14(9):674-675.

1. Köksal N, Müftüoglu T, Günerhan Y, et al. Management of intrabiliary ruptured hydatid disease of the liver[J]. Hepatogastroenterology, 2001, 48(40):1094-1096.
2. Bedirli A, Sakrak O, Sozuer EM, et al. Surgical management of spontaneous intrabiliary rupture of hydatid liver cysts[J]. Surg Today, 2002, 32(7):594-597.
3. Kayaalp C, Sengul N, Akoglu M. Importance of cyst content in hydatid liver surgery[J]. Arch Surg, 2002, 137(2):159-163.
4. 罗剑平. 木合然木. 肝包虫囊肿126例临床分析[J]. 中国普通外科杂, 2004, 13(3):236-237.
5. 余培东. 腹腔镜行肝脏边缘性包虫囊肿切除术的疗效观察[J]. 宁夏医学杂志, 2007, 29(12):1088-1089.
6. 李建勋, 高志刚, 李瑄, 等. 肝包虫残腔处理的探讨[J]. 临床军医杂志, 2009, 37(1):111, 116.
7. 柯重伟, 郑成竹. 腹腔镜外科手术学[M]. 上海:上海科学技术出版社, 2006:197.
8. 刘国礼. 现代微创外科学[M]. 北京:科学出版社, 2003:236-237.
9. 索朗次仁. 次仁伦珠, 扎西加措. 高原地区应用腹腔镜治疗肝包虫病11例报告[J]. 腹腔镜外科杂志, 2010, 15(2):119-120.
10. Saglam A. Laparoscopic treatment of liver hydatid cysts[J]. Surg Laparosc Endosc, 1996, 6(1):16-21.
11. Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cystic liver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
12. 黄志刚, 祝晓芬. 电动刨削器鼻内窥镜下腺样体切除术83例[J]. 陕西医学杂志, 2004, 33(5):438-439.
13. Cugat E, Olsina JJ, Rotellar F, et al. Initial results of the National Registry of Laparoscopic Liver Surgery[J]. Cirugía Española, 2005, 78(3):152-160.
14. Yagci G, Ustunsoz B, Kaymakcioglu N, et al. Results of surgical,laparoscopic, and percutaneous treatment for hydatid disease of the liver:10 years experience with 355 patients[J]. World J Surg, 2005, 29(12):1670-1679.
15. Ben Brahim M, Nouri A, Ksia A, et al. Management of multiple echinococcosis in childhood with albendazole and surgery[J]. J Pediatr Surg, 2008, 43(11):2024-2030.
16. Chen W, Xusheng L. Laparoscopic surgical techniques in patients with hepatic hydatid cyst[J]. Am J Surg, 2007, 194(2):243-247.
17. Avtan L. A new "Perforator Grinder-Aspirator Apparatus (PGAA)" for the minimal access surgery of cysti cliver hydatidosis[J]. Hepatogastroenterology, 2005, 52(62):339-342.
18. 廖霄斌, 赵晋明, 李介秋, 等. 腹腔镜肝包虫外囊剥离联合胆囊切除1例[J]. 中国普通外科杂志, 2009, 9(9):931-932.
19. 李荣梓, 柴福录, 肖毅, 等. 腹腔镜技术在肝包虫病治疗中的应用. 腹腔镜外科杂志[J]. 2009, 14(9):674-675.

West China Medical Journal

Control Study of Clinical Effect of the Surgery with Laparoscope and Choledochoscope on Plateau Hepatic Hydatid Biloary Fistulas

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