[Surgical treatment of echinococcosis of the liver].
Echinococcosis is a parasitic disease which is most frequently located in the liver. The treatment of choice is surgery.


METHODS
A total of 23 patients were hospitalised for liver echinococcosis during the period from January 1993 to September 1998.


RESULTS
The diagnosis was in 20 cases (87%) cystic echinococcosis and in 3 patients (13%) alveolar echinococcosis. The regular intervention of cyst desinfection with cystectomy was carried out in 85% of the cases with cystic echinococcosis, whereas atypical or segmental liver resections were performed in 15%. Two patients with alveolar echinococcosis were operated upon by radical/extended liver resections, one was found intraoperatively inoperable. The mean hospital stay was 15.4 days with a mortality of 0% and a postoperative morbidity of 57%, including bile leaks in 30%. A perioperative antiparasitic chemotherapy with albendazole was prescribed in 91%. The apparent rate of recurrence was 7% for uncomplicated cystic echinococcosis.


CONCLUSIONS
Cyst desinfection with cystectomy has been proved to be effective as the standard operative intervention for cystic echinococcosis. For alveolar echinococcosis, radical resections are required. Due to the risk of recurrence (especially in alveolar echinococcosis), the effectiveness of surgery should be improved by a perioperative chemotherapy with albendazole.
Klinik für Viszerale und Transplantationschirurgie, Universität Bern, Inselspital.
W
W
Uhl
H
H
Löffler
A
A
Zimmermann
O
O
Tcholakov
B
B
Gloor
M W
MW
Büchler
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D004444:Echinococcosis, Hepatic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004446:Echinococcus / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality
Chirurgische Therapie der Leber-Echinokokkose.