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Objective: To determine the role of laboratory parameters for the study of early diagnosis of liver echinococcosis (LE) complications. Methods: Carried out the results of a study of 147 patients with complicated LE – suppuration of echinococcal cysts (n=50) and mechanical jaundice (n=97). As a result of a general blood analysis for diagnosing complications of LE were studied biochemical analyzes and indicators of endogenous intoxication. Results: The results of the study showed that in patients with complicated LE – suppuration and mechanical jaundice, noticed an increase content of leukocytes in 67.3%, of eosinophils in 42.9% and accelerated ESR in 57.8% of cases. The leukocyte intoxication index (LII) in patients with suppurative echinococcal liver cysts was 4.3±0.06 units. In patients with mechanical jaundice, an increase in the activity of ASAT and ALAT was observed up to 52.4±0.07 and 64.3±0.05 IU/L, respectively. In addition, patients showed an increase in the level of urea (7.8±0.05 mmol/L) and creatinine (128.4±0.04 μmol/L). In severe cases of jaundice indicators of bilirubin exceeded 190 μmol/L, diene conjugates increased to 1.86±0.074 nmol/L, malondialdehyde to 8.15±0.4 μmol/L, and medium mass molecules to 0.5±0.04 c.u./L, procalcitonin – up to 5.6±0.04 ng/mL, C-reactive protein – up to 175.3±9.8 mg/L. Conclusion: Some indicators of the general and biochemical analysis of blood, as well as indicators of endogenous intoxication, can be very informative for the early diagnosis of complications of liver echinococcosis and determine the functional state of the liver. Laboratory indicators of functional state of the liver and the common state of the patients helps to choose the most rational surgery tactics, and thereby reduce the percentage of postoperative complications and mortality among these severe categories of patients. Keywords: Liver echinococcosis, complication, diagnosis, biochemical analyzes, endogenous intoxication.

Кафедра хирургических болезней № 1, Таджикский государственный медицинский университет им. Абуали ибни Сино, душанбе, республика Таджикистан Цель: улучшение результатов лечения больных эхинококкозом печени путём использования миниинвазивных технологий. Материал и методы: приведены результаты обследования и лечения 23 пациентов с эхинококкозом печени. Женщин было 15 (65%), мужчин -8 (35%) в возрасте от 24 до 83 лет. В зависимости от особенностей клинической ситуации использовали 2 варианта оперативного лечения: 1) пунктирование и дренирование кистозной полости под УЗ контролем; 2) вскрытие и обработка кистозной полости с помощью лапароскопической техники. Результаты: лапароскопическая эхинококкэктомия выполнена 13 (56%) больным, пункция и дренирование эхинококковой кисты печени под УЗ контролем -10 (44%) больным. Послеоперационный период после малоинвазивных вмешательств по поводу эхинококкоза печени протекал значительно легче. Цистобилиарные свищи наблюдались в 3 наблюдениях, что потребовало выполнения дополнительных чресфистульных медикаментозных вмешательств. Ещё в 2 наблюдениях после пункционно-дренирующих вмешательств под УЗ контролем отмечено нагноение остаточной полости с увеличением в ближайшие сутки её размера по сравнению с исходным, что потребовало повторного их дренирования. Заключение: минимально инвазивные методы эхинококкэктомии с применением лапароскопической техники и чрескожное удаление эхинококковой кисты под контролем ультразвука, являются малотравматичными процедурами и могут быть альтернативой открытым хирургическим вмешательствам. Это способствует снижению частоты послеоперационных осложнений, особенно у лиц пожилого и старческого возраста с сопутствующими заболеваниями. Ключевые слова: эхинококкоз печени, миниинвазивные технологии, лапароскопия, чрескожное удаление, кистозная полость, чресфистульные вмешательства.Для цитирования: Азиззода ЗА, Курбонов КМ, Ризоев ВС. Малоинвазивные оперативные вмешательства при эхинококкозе печени. Вестник Авиценны. 2019;21(1):116-20. Available from: http://dx.Objective: Improving the results of treatment of patients with liver echinococcosis by using minimally invasive technology. Methods: The results of the examination and treatment of 23 patients with liver echinococcosis are presented. There were 15 women (65%), and 8 men (35%) aged from 24 to 83 years. Depending on the peculiarities of the clinical situation, 2 options for surgical treatment were used: 1) puncturing and drainage of the cystic cavity under ultrasound control; 2) opening and processing of the cystic cavity using laparoscopic techniques. Results: Laparoscopic echinococcectomy was performed in 13 (56%) patients, puncture and drainage of the echinococcus cyst under ultrasound control -10 (44%) patients. The postoperative period was much easier after minimally invasive interventions for liver echinococcosis. Cystobiliary fistulae were observed in 3 cases, which required additional transfistula medical interventions. In 2 more cases after puncture-draining interventions under ultrasound con...

Objective: To evaluate the results of using minimally invasive technologies in the surgical treatment of hepatic echinococcosis (HE) and its complications. Methods: The results of examination and surgical treatment of 165 patients with HE and its complications using minimally invasive technologies are presented. Results: 77 patients with uncomplicated HE underwent: open echinococcectomy (EE) from various mini-accesses (n=37), laparoscopic EE (n=30), PAIR technology (n=6), hepatic resection using the da Vinci S robotic complex (n=4). In patients with suppurated hydatid cysts (n=49) a combination of percutaneous cyst puncture with laparoscopic (4) and open (5) EE; PAIR technology (5) and laparoscopic EE (35) were performed. All 39 patients with intrabiliary rupture of hydatid cysts underwent two-stage interventions: percutaneous transhepatic choledochostomy followed by laparoscopic (7) and traditional (4) EE; endoscopic papillosphincterotomy (EPST) followed by open EE (9); laparoscopic choledochostomy followed by open EE (3); EPST followed by laparoscopic total (2) and subtotal (14) pericystectomy. Postoperative complications were noted in 29 (17.5%), relapses of the disease – in 12 (10.9%), lethal outcome – in 1 (0.6%) cases. Based on the analysis of the study, an algorithm for choosing the method of surgical treatment for HE and its complications was developed. Conclusions: The use of minimally invasive technology for hepatic echinococcosis can improve surgical treatment outcomes. Keywords: Hepatic echinococcosis, diagnosis , minimally invasive technologies, surgical treatment, treatment results.

Aim. Improving outcomes of diagnosis and treatment of patients with liver echinococcosis and its complications. Materials and methods. A comparative analysis of the results of surgical treatment of liver echinococcosis and its complications with traditional laparotomy access surgery (control group) and minimally invasive interventions (main group) was performed.Results. The study included 300 patients (170 in the control and 130 in the main group). In the main group, 37 (28.4%) cases performed open echinococcectomy from various mini-accesses, and 27 (20.7%) performed twostage operations using minimally invasive technology. Laparoscopic echinococcectomy was performed in 23 (17.7%) patients, laparoscopic pericystectomy 12 (9.2%) and laparoscopic liver resection in 10 (7.7%) patients. The frequency of postoperative complications in the main group was 17.7%, in the control 51.8%, postoperative mortality decreased from 2.3% to 0.8%.Conclusion. Minimally invasive technologies in the surgical treatment of liver echinococcosis show the better immediate results compared to traditional open surgical methods.