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Objective To evaluate the clinical pathway (CP) for treatment of hepatic cystic echinococcosis.Methods Data were retrospectively obtained from hospitalized patients with hepatic cystic echinococcosis (CE) who were treated surgically between April 2011 to December 2012.Patient treated with the clinical pathway (the CP group) were compared with patients who were treated with conventional treatment (the non-CP group).The following outcomes were compared:the average length of in-hospital stay,the hospital charges,patient's satisfaction,patient's knowledge about his/ her own health and postoperative complications.Results For the CP groups,the length of in-hospital stay,the hospital charges,the patient's satisfaction and the health knowledge for the patients were (10.25±1.26)d,(19600.25±1520.73) yuan,(46.4 5±2.14),(83.50±8.02),respectively.The corresponding figures for the non-CP group were (14.25 ± 1.50) d,(23931.25 ± 1629.17) yuan,(42.65 ± 1.93),(74.50 ± 12.60),respectively.There were significant differences between the 2 groups (t=-4.086,-4.074,8.351,3.811 ; P＜0.05).The postoperative complications,including bile leakage,bleeding,ascites and pleural effusion,were 2,0,2 cases in the CP group,and 0,4,5 cases in the non-CP group.There were no significant difference between the 2 groups (x2 =0.17,0,0.6; P＞0.05).Conclusion Our initial clinical experience showed that the clinical pathway decreased the length of in-hospital stay and hospital charges,and provided quality and efficient clinical services to patients with hepatic cystic echinococcosis.
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<p><b>BACKGROUND</b>Alveolar echinococcosis located in the adrenal gland can be considered a rare and aggressive infestation that radiologically and macroscopically mimics a malignant neoplasm. Its pathogenesis is poorly understood. This paper describes its clinical and radiological aspects and discusses its proper management.</p><p><b>METHODS</b>The records of two patients with adrenal gland alveolar echinococcosis who were diagnosed and treated in our center in 2009 were evaluated.</p><p><b>RESULTS</b>Neither patient showed any signs of recurrence following radical surgical treatment and postoperative oral anthelmintic therapy.</p><p><b>CONCLUSION</b>Radical surgery can be a feasible, effective management option that results in a good prospective outcome.</p>
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Female , Humans , Male , Middle Aged , Adrenal Glands , Pathology , General Surgery , Echinococcosis, Hepatic , Diagnosis , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To explore and compare the clinical effect and safety of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) in the treatment of cystic echinococcosis (CE1, CE2, and CE3).</p><p><b>METHODS</b>A total of 269 cases treated with cystic echinococcosis (CE) in Xinjiang Medical University the First Affiliated Hospital from 1998 to 2008 were reviewed. 51 cases were excluded and 218 cases were enrolled in this research by retrospective case-control method. Among 110 cases were treated with L-ABZ and 108 cases were treated with T-ABZ for short-term (3 months) and long-term courses (6 months) respectively. The effects and safety of the two medicines were compared by analyzing the clinical symptoms, imaging check and serologic test results.</p><p><b>RESULTS</b>In short-term effect evaluation, the total effective rates and curative rates of L-ABZ group and T-ABZ group were 77.9% and 49.1% vs 28.4% and 13.9%, respectively. The effects of L-ABZ group was better than that of T-ABZ group, with remarkable difference in total effective rates and curative rates (x2 value was 19.581, 6.877, respectively, P is less than 0.05). In long-term effect evaluation, the total effective rates and curative rates of L-ABZ and T-ABZ group were 81.7% and 49.0% vs 47.6% and 20.6%, respectively. There was significant difference between L-ABZ group and T-ABZ group in total effective rates and curative rates (x2 value was 20.977, 15.049, respectively, P is less than 0.05). In T-ABZ group the short-term curative rates were 50.0% (15/30), 8.8% (8/91) and 33.3% (7/21) respectively in CE1, CE2, and CE3, the short-term total effective rates were 56.7% (17/30), 35.2% (32/91) and 61.9% (13/21) respectively in CE1, CE2, and CE3. The long-term curative rates were 58.3% (7/12), 28.6% (12/42) and 70.0% (7/10) respectively in CE1, CE2 and CE3, the long-term total effective rates were 75.0% (9/12), 69.0% (29/42) and 100.0% (10/10) respectively in CE1, CE2, and CE3. When compared with CE2, differences existed in CE1 (x2 = 24.887, 4.329; P is less than 0.05) and CE3 groups (x2 = 8.860, 5.076; P is less than 0.05) in terms of short-term effects. In L-ABZ group, the short-term curative rates were 47.4% (18/38), 12.2% (12/98) and 61.5% (8/13) respectively in CE1, CE2 and CE3, the short-term total effective rates were 92.1% (35/38), 65.3% (64/98) and 92.3% (12/13) respectively in CE1, CE2 and CE3, the long-term curative rates were 79.3% (23/29), 35.9% (23/64) and 50.0% (3/6) respectively in CE1, CE2 and CE3, the long-term total effective rates were 96.6% (28/29), 84.4% (54/64) and 100% (6/6) respectively in CE1, CE2 and CE3. When compared with CE2, there were significant differences in CE1 (x2 = 19.648, 9.930; P is less than 0.05) and CE3 groups (x2 = 18.880, 3.876; P is less than 0.05) in terms of short-term effect. In L-ABZ and T-ABZ groups, the drug-related adverse effects were 11.1% (12/108) and 12.7% (14/110) respectively without significant difference (x2 = 0.155, P is more than 0.05).</p><p><b>CONCLUSION</b>L-ABZ and T-ABZ were both effective anti-echinococcosis drugs without dominant side-effects. The clinical effect of L-ABZ was better than that of T-ABZ.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Albendazole , Therapeutic Uses , Echinococcosis , Drug Therapy , Liposomes , Retrospective Studies , TabletsABSTRACT
Objective To investigate the evolution of surgical treatment and it's influence on prognosis in reptured liver cystic echinococcosis.Method Clinical data of 110 surgically treated cases of reptured liver cystic echinococcosis from January 1990 to December 2008 were retrospectively analysed,and these cases were divided into three groups by different surgical approach;Group A(22 cases):removal of internal capsule,with formaldehyde or hydrogen peroxide regional anthelminthic,with residual cavity side edge of lock stitching or greater omentum filling or drainage after residual cavity closure;Group B (65 cases):Removal of intemal capsule,with hypertonic saline regional anthelminthic,with external capsule extrahepatic partial resection,with residual cavity bile leakage sutured,and with residual cavity open drainage,Group C(23 cases):the total or subtotal external capsule stripping operation,with hypertonic saline regional anthelminthic and drainage.Result The rate of overall postoperative complications of residual cavity was 40.9%、16.9%、0.0%(P<0.05)respectively and the recurrence rate was 18.2%、4.6%、0.0%(P<0.05)respectively;drainage time needed was the longest in group A,and shortest in group C,whereas the operation time was the longest in group C and it costed higher blood loss.Intraabdominal implantation of the hydatid significantly decreased with hypertonic saline treatment.Conclusion Total or near total removal of the external capsule of the hydatic cyst and hypertonic saline treatment with postoperative external drainage is the therapy of choice for reptured liver cystic echinococcosis.
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Objective To review our experience in treatment of liver hydatid diease.Methods The data of 819 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively.Exploration of common bile duct was done in 172 cases.There were men 95 and women 77with a mean age of 31.5±0.5 years.In addition to treatment of the cyst cavity,patients was divided into two groups.The patients in group A received cholangiography and exploration of common bile duct through cystic duct while those in group B underwent cholangiography and common bile duct ex-pioration through T tube.Results The length of hospital stay and cavity-related problems for both groups had no significant difference.Biliary tract-related problems in two groups had significant differ-ence.Conclusion Cholangiography and common bile duct exploration through cystic duct can com-pletely solve the cavity-related problems while avoiding T-tube related problems.