title: Treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture by pericystectomy in combination with Roux-en-Y hepaticojejunostomy.
abstract: This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.
authors.affiliation: Center of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.|Department of Hepatobiliary Surgery, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Hongqiang
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Social Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.|Department of Preventive Medicine of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Jingxia
authors.initials: J
authors.lastname: Tang
authors.affiliation: Center of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.|Department of Hepatobiliary Surgery, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Xinyu
authors.initials: X
authors.lastname: Peng
authors.affiliation: Center of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.|Department of Hepatobiliary Surgery, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Shijie
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Hailong
authors.initials: H
authors.lastname: Lv
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of the Medical College, Shihezi University, Shihezi, 832000, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Center of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. chenxp@medmail.com.cn.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Chen
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D015653:Cystectomy / Q000379:methods*; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008297:Male; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome