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Abstract：
BACKGROUND: Hydatid cyst disease (HCD) is common in certain locations. Surgery is associated with postoperative biliary fistula (POBF) and recurrence. The primary aim of this study was to identify whether occult cysto-biliary communication (CBC) can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and alkaline phosphatase (ALP) levels in predicting POBF and recurrent HCD.
OBJECTIVE: To identify whether occult CBC can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD.
METHODS: From September 2010 to September 2016, a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty. Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence.
RESULTS: There was a highly statistically significant association (P ≤ 0.001) between cystic fluid biochemical indices and the development of biliary complications (of 16 patients with POBF, 15 patients had high cyst fluid bilirubin and ALP levels), where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications. There was a highly statistically significant association (P ≤ 0.001) between biliary complications, biochemical indices, and the occurrence of recurrent HCD (of 30 patients with recurrent HCD, 15 patients had high cyst fluid bilirubin and ALP; all 16 patients who had POBF later developed recurrent HCD), where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts, respectively.
CONCLUSIONS: Occult CBC can predict recurrent HCD. Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD.
OBJECTIVE: To identify whether occult CBC can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD.
METHODS: From September 2010 to September 2016, a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty. Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence.
RESULTS: There was a highly statistically significant association (P ≤ 0.001) between cystic fluid biochemical indices and the development of biliary complications (of 16 patients with POBF, 15 patients had high cyst fluid bilirubin and ALP levels), where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications. There was a highly statistically significant association (P ≤ 0.001) between biliary complications, biochemical indices, and the occurrence of recurrent HCD (of 30 patients with recurrent HCD, 15 patients had high cyst fluid bilirubin and ALP; all 16 patients who had POBF later developed recurrent HCD), where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts, respectively.
CONCLUSIONS: Occult CBC can predict recurrent HCD. Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD.
摘要：
背景：包虫囊肿病（HCD）在某些地区很常见。手术与术后胆瘘（POBF）和复发有关。这项研究的主要目的是确定隐匿性膀胱-胆道通讯（CBC）是否可以预测复发性HCD。次要目的是评估囊液胆红素和碱性磷酸酶（ALP）水平在预测POBF和复发性HCD中的作用。
目的：确定隐匿性CBC是否可以预测复发性HCD。次要目的是评估囊液胆红素和ALP水平在预测POBF和复发性HCD中的作用。
方法：从2010年9月至2016年9月，进行了一项前瞻性多中心研究，涉及244例单发原发性浅表期囊性包虫病2和囊性包虫病3bHCD患者，这些患者接受了腹腔镜下膀胱部分切除术和网膜成形术。单变量logistic回归分析评估了决定胆道并发症和复发的独立因素。
结果：囊性液体生化指标与胆道并发症的发展之间存在高度统计学上的显着关联（P≤0.001）（在16例POBF患者中，15例患者囊液胆红素和ALP水平较高)，胆红素-ALP水平高的患者发生胆道并发症的可能性是后者的3405倍.胆道并发症之间有高度统计学显著的关联（P≤0.001），生化指标,和复发性HCD的发生（30例复发性HCD患者，15例患者有高囊肿液胆红素和ALP；所有16例POBF患者后来都发展为复发性HCD），发生胆道并发症和高胆红素-ALP的患者发生包虫囊肿的可能性分别为244.6和214倍，分别。
结论：隐匿性CBC可以预测复发性HCD。囊肿液胆红素和ALP水平升高可预测POBF和复发性HCD。
目的：确定隐匿性CBC是否可以预测复发性HCD。次要目的是评估囊液胆红素和ALP水平在预测POBF和复发性HCD中的作用。
方法：从2010年9月至2016年9月，进行了一项前瞻性多中心研究，涉及244例单发原发性浅表期囊性包虫病2和囊性包虫病3bHCD患者，这些患者接受了腹腔镜下膀胱部分切除术和网膜成形术。单变量logistic回归分析评估了决定胆道并发症和复发的独立因素。
结果：囊性液体生化指标与胆道并发症的发展之间存在高度统计学上的显着关联（P≤0.001）（在16例POBF患者中，15例患者囊液胆红素和ALP水平较高)，胆红素-ALP水平高的患者发生胆道并发症的可能性是后者的3405倍.胆道并发症之间有高度统计学显著的关联（P≤0.001），生化指标,和复发性HCD的发生（30例复发性HCD患者，15例患者有高囊肿液胆红素和ALP；所有16例POBF患者后来都发展为复发性HCD），发生胆道并发症和高胆红素-ALP的患者发生包虫囊肿的可能性分别为244.6和214倍，分别。
结论：隐匿性CBC可以预测复发性HCD。囊肿液胆红素和ALP水平升高可预测POBF和复发性HCD。
