Analysis of relevant factor and treatment evaluation of liver hydatid cyst rupture

doi:10.3877/cma.j.issn.2095-3232.2017.06.015

Abstract

Abstract:

Objective

To investigate the relevant factors and treatment effect of liver hydatid cyst rupture.

Methods

Fifty literatures related to liver hydatid cyst rupture published between January 1988 and December 2014 were electronically retrieved from PubMed, ISI Web of Knowledge, CNKI, Google Scholar, EMBASE, Wanfang database and VIP database. The Chinese and English keywords were liver hydatid cyst, hydatid cyst echinococcosis and rupture. Twenty-seven literatures consisted of 9 foreign studies and 18 domestic studies. Among 2 511 patients, 731 cases were diagnosed with liver hydatid cyst rupture. The relevant factors, diagnostic and therapeutic measures and treatment effect of liver hydatid cyst rupture were analyzed.

Results

Among 731 patients with liver hydatid cyst rupture, 467 cases were male and 264 were female, aged 11-69 years old with a median age of 32 years old. Among them, 690 cases were from China, 25 from Turkey, 15 from India and 1 from Africa. The liver hydatid cysts of 200 cases were found in the right lobe and 36 cases in the left lobe, while no information about 495 cases. 103 cases were found with the ruptured cysts diameter >10 cm, 8 cases were 5-10 cm, while no information about 620 cases. Among them, 93 cases were diagnosed with traumatic rupture, 42 with spontaneous rupture, 4 with iatrogenic rupture, 2 with intra-abdominal pressure elevation and no data in 590. Emergency surgery was primarily adopted. Biliary tract irrigation combined with T catheter drainage was performed for patients with biliary tract involvement, and endocystectomy or partial hepatectomy combined with peritoneal lavage was performed for patients with abdominal cavity involvement. Postoperatively, albendazole was administered for 1.5-12.0 months in most patients. The postoperative follow-up time was 0.5-4.0 years. During follow-up, liver hydatid cyst recurred in 28 cases, no recurrence in 404 and no data in 299. For the treatment effect, 447 cases survived, 22 were misdiagnosed or died and no data in 262.

Conclusions

Liver hydatid cyst rupture is mainly found in middle aged males in endemic area. Locating in the right lobe of liver, cyst diameter >10 cm and trauma are the primary relevant factors for rupture. Emergency operation to thoroughly eliminate the lesions and cystic fluid is the crucial procedure. Postoperative administration of albendazole can effectively prevent the recurrence of liver hydatid cyst.

Key words: Echinococcosis, hepatic, Rupture, Treatment outcome

Ruitao Wang, Qing Li, Huan Liang, Yong Wan, Shunbin Dong, Kai Qu, Chang Liu. Analysis of relevant factor and treatment evaluation of liver hydatid cyst rupture[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2017, 06(06): 484-488.

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