Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst

Sürmelioğlu, Ali; Özer, İlter; Reyhan, Enver; Dalgıç, Tahsin; Özdemir, Yılmaz; Ulaş, Murat; Bostancı, Erdal Birol; Akoğlu, Musa

doi:10.1177/000313481708300119

Cited by 17 publications

(19 citation statements)

References 22 publications

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“…Demircan et al [ 9 ] pointed out that high ALP levels in patients are a strong risk factor for cystic echinococcal bile leakage. Surmelioglu et al [ 12 ] divided ALP into five grades (normal, 2, 3, 4, 5 and >5) in clinical studies of complications associated with cystic echinococcosis biliary leakage. The results suggest that the risk of CBC increases by 2.5 times for every grade of ALP.…”

Section: Discussionmentioning

confidence: 99%

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Nomogram Analysis and Internal Validation to Predict the Risk of Cystobiliary Communication in Patients Undergoing Hydatid Liver Cyst Surgery

Zhan

Pang

et al. 2020

World j. surg.

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Purpose Biliary leakage caused by cystobiliary communication (CBC) is a common clinical concern. This study sought to identify predictors of CBC in hepatic cystic echinococcosis (HCE) patients undergoing hydatid liver cyst surgery and establish nomograms to predict CBC. Methods A predictive model was established in a training cohort of 310 HCE patients diagnosed between January 2013 and May 2017. Upon revision of the records of clinical parameters and imaging features of these patients, the lasso regression model was used to optimize feature selection for the CBC risk model. Combined with feature selection, a CBC nomogram was developed with multivariable logistic regression. C-index and calibration plots were used to analyze and evaluate the discrimination and calibration. The net benefit and predictive accuracy of the nomogram were performed via decision curve analysis (DCA) and receiver operating characteristic (ROC) curve. An independent validation cohort of 132 patients recruited from June 2017 to May 2019 was used to evaluate the practicability of the nomogram. Results Predictors contained four features, namely alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), cyst size and cyst location. The C-index of the nomogram is 0.791 (95% CI, 0.736–0.845), while the C-index verified by bootstrap is 0.746, indicating high prediction accuracy. The area under the curve (AUC) of the CBC in training was 0.766. ROC curve analysis demonstrated high sensitivity and specificity. Decision curve analysis confirmed the CBC nomogram was clinically useful when the intervention was determined at the non-adherence possibility threshold of 8%. Conclusion The nomogram developed using the ALP, GGT, cyst size and cyst location could be used to facilitate the CBC risk prediction in HCE patients.

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Section: Discussionmentioning

confidence: 99%

“…[ 2 ]. Surgical treatment is commonly used for CE, but regardless of the type of operation used, bile leakage is the most common complication after CE surgery [ 3 ]. In fact, it is one of the main causes of increased mortality and prolonged hospital stay in patients with cystic echinococcosis.…”

Section: Introductionmentioning

confidence: 99%

Nomogram Analysis and Internal Validation to Predict the Risk of Cystobiliary Communication in Patients Undergoing Hydatid Liver Cyst Surgery

Zhan

Pang

et al. 2020

World j. surg.

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“…It can lead to malnutrition and emaciation [ 22 ]. Echinococcosis is usually found in the liver, but can also be transferred to the abdominal cavity, lungs, brain and other organs [ 19 , 20 , 24 ]. It has the characteristics of slow onset and occult onset.…”

Section: Discussionmentioning

confidence: 99%

Nutritional status and screening tools to detect nutritional risk in hospitalized patients with hepatic echinococcosis

Zhan

Song

et al. 2020

Parasite

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Background: Echinococcosis is a chronic consumptive liver disease. Little research has been carried out on the nutritional status of infected patients, though liver diseases are often associated with malnutrition. Our study investigated four different nutrition screening tools, to assess nutritional risks of hospitalized patients with echinococcosis. Methods: Nutritional Risk Screening 2002 (NRS 2002), Short Form of Mini Nutritional Assessment (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the Nutrition Risk Index (NRI) were used to assess 164 patients with alveolar echinococcosis (AE) and 232 with cystic echinococcosis (CE). Results were then compared with European Society for Clinical Nutrition and Metabolism (ESPEN) criteria for malnutrition diagnosis. Results: According to ESPEN standards for malnutrition diagnosis, 29.2% of CE patients and 31.1% of AE patients were malnourished. The malnutrition risk rates for CE and AE patients were as follows: NRS 2002 – 40.3% and 30.7%; MUST – 51.5% and 50.9%; MNA-SF – 46.8% and 44.1%; and NRI – 51.1% and 67.4%. In patients with CE, MNA-SF and NRS 2002 results correlated well with ESPEN results (k = 0.515, 0.496). Area-under-the-curve (AUC) values of MNA-SF and NRS 2002 were 0.803 and 0.776, respectively. For patients with AE, NRS 2002 and MNA-SF results correlated well with ESPEN (k = 0.555, 0.493). AUC values of NRS 2002 and MNA-SF were 0.776 and 0.792, respectively. Conclusion: This study is the first to analyze hospitalized echinococcosis patients based on these nutritional screening tools. Our results suggest that NRS 2002 and MNA-SF are suitable tools for nutritional screening of inpatients with echinococcosis.

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“…With the mature application of laparoscopy in hepatobiliary surgery, laparoscopic treatment of hepatic cystic echinococcosis has made great progress and achieved good results [6] . Endo-cystectomy is related withhigher incidence of residual cavity complications (8.28% ~ 65.8%), recurrence rate (1.5% ~ 36.6%), and reoperation rate (2.2% ~ 3.2%) as well as biliary stula (19.4%) compared to pericystectomy [7] . As radical modality option, pericystectomy and hepatectomy hydatid signi cantly reduce the risk of postoperative complication [8] .…”

Section: Discussionmentioning

confidence: 99%

The Application of Laparoscopy Combined With Indocyanine Green Fluorescence Imaging Technique for Hepatic Cystic Echinococcosis

et al. 2020

Preprint

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BACKGROUND: With the mature application of laparoscopy in hepatobiliary surgery, laparoscopic treatment of hepatic cystic echinococcosis(CE) has made certain progress. But, due to the inherent limitations of laparoscopy and the growth characteristics of cystic echinococcosis, distinguishing the boundary between cystic lesion and normal hepatic parenchyma is pivotal importance for successful sugery. Indocyanine green(ICG) fluorescence imaging technology can view the boundary of lesion and normal tissue during the treatment of hepatic cystic echinococcosis. Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis may be an effective surgical strategy.AIM: To report and discuss single center experience of indocyanine green fluorescence imaging during laparoscopic management of hepatic cystic echinococcosis patients.METHODS: The clinical data contained nine patients with hepatic cystic echinococcosis who underwent laparoscopic surgery with indocyanine green fluorescence imaging technique in authors’ institution from December 2018 to December 2019 were retrospectively analyzed. Indocyanine green was administered intravenously three days prior to surgery. The fluorescence acquisition system for real-time imaging was used during the surgery and the patients were followed up after surgery. RESULTS: Of reported nine patients, six are male and the remaining three are female. The average age is (36.5 ± 7.6) years with their body weight (70.6 ± 7.2) kg. For all subjects, surgical procedures were performed under laparoscopy with indocyanine green fluorescence system. This technique showed the clear boundary of the hepatic cyst with normal liver paranchyma. Total cystectomy in six patients, subtotal cystectomy in two patients and partial hepatectomy in one patient were performed repectively. The average operation time was 228 ± 54 minutes, blood loss 206.3 ± 120.8 ml. Neither blood transfusion nor post-operative complication was experienced. The average abdominal drainage time was 3.4 ± 0.9 days with hospital stay 5.7 ± 2.1 days. During the 6-12 months follow-up period, neither recurrence nor intraperitoneal implantation was found.CONCLUSION: Applied laparoscopy combined with ICG fluorescence imaging technique for hepatic cystic echinococcosis is safe and feasible. Enhanced boundary image can assist surgeons to complete radical resection and reduce complications.

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Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst

Cited by 17 publications

References 22 publications

Nomogram Analysis and Internal Validation to Predict the Risk of Cystobiliary Communication in Patients Undergoing Hydatid Liver Cyst Surgery

Nomogram Analysis and Internal Validation to Predict the Risk of Cystobiliary Communication in Patients Undergoing Hydatid Liver Cyst Surgery

Nutritional status and screening tools to detect nutritional risk in hospitalized patients with hepatic echinococcosis

The Application of Laparoscopy Combined With Indocyanine Green Fluorescence Imaging Technique for Hepatic Cystic Echinococcosis

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