The choose of different surgical therapies of hepatic alveolar echinococcosis

Abstract

The aim of this study was to evaluate different surgical therapies for hepatic alveolar echinococcosis in different clinical stages.We analyze the clinical data of 115 patients who received surgical treatment in West China Hospital from January 2004 to June 2016. Among these patients, 77 cases underwent radical hepatic resection (group A, n = 77); 17 cases underwent palliative resection (group B, n = 17), and 21 cases underwent liver transplantation (group C, n = 21) with 12 cases of orthotopic liver transplantation and 9 cases of liver autotransplantation.The postoperative complication rate of radical hepatic resection group was 13.0% (10/77), which is statistically significant (P < .05) than the rate of palliative resection group 29.4% (5/17) or liver transplantation group 23.8% (5/21). The follow-up period ranged from 1 to 72 months. The overall median survival rate of radical resection was 72/77, higher than the rate of palliative group (12/17) or transplantation group (17/21), which was also statistically significant (P < .01).In our study, we believe in that all stages of hepatic alveolar echinococcosis should take active surgical interventions, and radical hepatic resection should be considered as the first-choice treatment for early stage of alveolar echinococcosis, while palliative surgery is still helpful to relieve symptoms and improve the life quality for advanced patients. Liver transplantation might also be an alternative option for the late-stage hepatic alveolar echinococcosis.

Magnetic resonance imaging evaluation of characteristics of vascular invasion in intermediate and advanced hepatic alveolar echinococcosis

“…Surgery is also an effective method for treating this disease (6,7). However, radical resection may be difficult, as the parasite exhibits an invasive growth and tends to invade intrahepatic vessels in particular (8).…”

Successful surgical management of hepatic alveolar echinococcosis by inductive therapy with albendazole – a case report

“…Perioperative and long-term adjuvant chemotherapy with albendazole (a dosage of 10-15 mg/kg per day is recommended, but doses up to 20 mg/kg may be necessary in individual patients. ), which is only parasitostatic against the E. multilocularis metacestode, is associated with an 80 %-100 % 10-year survival; this rate is considerably higher than that of controls, which is less than 25 % [2,5]. Adjuvant chemotherapy with albendazole should continue for 2 years post-surgery in patients with complete resection, and long-term follow-up by should be provided by means of annual sectional imaging (ultrasound and possibly CT performed at a center with relevant experience).…”

“…Radical surgery, as for hepatic malignancy, has historically been the first-line treatment for AE, reaching 5-year survival rates of 100 % [1,5]. Perioperative and long-term adjuvant chemotherapy with albendazole (a dosage of 10-15 mg/kg per day is recommended, but doses up to 20 mg/kg may be necessary in individual patients.…”

Surgical Treatment of Hepatic Hydatidosis

“…This pathology affects different organs, although the liver is the most commonly compromised, accounting for 70-75% of the cases. Alveolar echinococcosis caused by E. multilocularis is restricted to the Northern Hemisphere and might determine high morbidity and mortality [13]. Polycystic echinococcosis is caused by E. vogeli and only reported in Central and South America with low incidence rates [14].…”