Application analysis of selective blocking of hepatic artery blood in external capsule excision for hepatic cystic echinococosis / 中华肝胆外科杂志

ABSTRACT

Objective:To study the impact of selective occlusion of hepatic arterial blood flow in external capsule excision for hepatic cystic echinococcosis.Methods:A retrospective analysis was conducted on the data of 80 patients with hepatic cystic echinococcosis who underwent surgical treatment from January 2017 to January 2019 in the First Affiliated Hospital of Xinjiang Medical University. There were 36 males and 44 females, with an average age of 47 years. All patients underwent external capsule excision of hepatic cystic echinococcosis. According to the type of intraoperative blood flow occlusion, the patients were divided into group A ( n=42), selective occlusion of hepatic artery; group B ( n=38), Pringle’s maneuvre. The hospitalization stay, intraoperative blood loss, postoperative ventilation time and complications were compared between the two groups. The postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, and total bilirubin were compared between the two groups. Results:The intraoperative blood loss (215.7±29.6) ml, postoperative ventilation time (2.3±0.1)d, and hospital stay (11.6±1.0) d in group A were better than those in group B (254.8±20.6) ml, (3.2±0.2) d, (12.7±0.7) d, the differences were significant (all P<0.05). There were 4 patients (9.5%) who developed postoperative complications in group A and 5 patients (13.2%) in group B. There was no significant difference between the two groups ( P>0.05). Group A had better ALT, AST, albumin, and total bilirubin on day 3 after operation, and the differences were significant (all P<0.05). The ALT (62.8±5.2) U/L, AST (32.7±2.6) U/L, albumin (39.1±0.3) g/L, total bilirubin (12.1±0.5) μmol/L in Group A were better than group B (121.9±5.6) U/L, (53.9±8.0) U/L, (32.2±0.6) g/L, (19.3±0.9) μmol/L on day 5 after operation, the differences were significant (all P<0.05). Conclusion:Selective occlusion of the hepatic artery in external capsule excision for hepatic cystic echinococcosis was superior to the traditional Pringle’s maneuver in controlling intraoperative bleeding and postoperative liver function recovery.