Treatment of Complicated Hepatic Cystic Hydatidosis with Intrabiliary Rupture by Pericystectomy in Combination with Roux-en-Y Hepaticojejunostomy / 华中科技大学学报（医学）（英德文版）

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 Ⅵin 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.