PDF(Pubmed)
Abstract：
Hydatid cyst disease is a parasitic ailment with an endemic nature, predominantly affecting geographical areas with a tradition in animal husbandry. The most common localization of hydatid disease is in the liver (60%), followed by the lungs, with other organ localizations comprising less than 10%. The surgical approach to this condition can be carried out through open surgery or laparoscopy. The coexistence of hepatic and intraperitoneal hydatidosis often leads to the preference for open surgery. We performed a literature review aiming to retrieve data regarding demographic characteristics, clinical features, preoperative management, and surgical approach concerning these unusual localizations of hydatid disease. It was observed that the mesenteric localization frequently presented with acute abdominal pain (p = 0.038) and that the open approach was preferred in 85.71% of cases. Furthermore, an interdependence was identified between the localization of the cysts and the type of surgical approach (p = 0.001), with mesenteric localizations being approached through laparotomy and excision (p = 0.037), while omental localizations, due to the easier approach, benefited from laparoscopy with excision in 14.29% of cases. Overall, the laparoscopic approach was less frequently used, but its utilization resulted in a lower number of complications and faster recovery. Additionally, we present a rare case of hepatic and intra-abdominal hydatidosis, resolved exclusively through a laparoscopic approach, including a review of the literature for these uncommon localizations of hydatid disease. A 45-year-old patient diagnosed with multiple hydatid cysts, both hepatic and intraperitoneal, underwent surgical intervention with exploratory laparoscopy. Laparoscopic excision of peritoneal, epiploic, mesenteric cysts, and round ligament, along with laparoscopic inactivation, evacuation, and pericystectomy of hepatic hydatid cysts, was performed. The patient\'s recovery was uneventful, and she was reevaluated at 3 and 9 months without signs of recurrence. The association of hepatic hydatid cysts with multiple intra-abdominal localizations is not commonly encountered. The treatment of choice is surgical and is predominantly conducted through open surgery. The presented case is unique due to the exclusive laparoscopic approach in the management of mixed hepatic and intra-abdominal hydatidosis.
摘要：
包虫囊肿病是一种地方性的寄生性疾病,主要影响具有畜牧业传统的地理区域。包虫病最常见的定位是在肝脏（60％），其次是肺，其他器官定位占不到10%。这种情况的手术方法可以通过开放手术或腹腔镜检查进行。肝和腹膜内包虫病的共存通常导致对开放手术的偏爱。我们进行了文献综述，旨在检索有关人口统计学特征的数据，临床特征,术前管理,以及关于包虫病这些不寻常局部化的手术方法。观察到肠系膜定位常伴有急性腹痛（p=0.038），在85.71％的病例中首选开放方法。此外，在囊肿的定位和手术方法的类型之间确定了相互依存的关系（p=0.001），肠系膜定位是通过剖腹手术和切除（p=0.037），而网膜定位，由于更容易的方法，14.29%的病例受益于腹腔镜手术切除。总的来说,腹腔镜方法使用频率较低，但它的使用导致较少数量的并发症和更快的恢复。此外,我们介绍了一个罕见的肝和腹内包虫病，完全通过腹腔镜方法解决，包括对这些罕见的包虫病局部化的文献的回顾。一名45岁的患者被诊断患有多发性包虫囊肿，肝脏和腹膜内，行手术干预与探查性腹腔镜检查。腹腔镜腹膜切除术，表皮,肠系膜囊肿,和圆形韧带，随着腹腔镜灭活，疏散,和肝包虫囊肿的子宫周切除术，已执行。病人的康复顺利，在3个月和9个月时对她进行了重新评估，没有复发的迹象。肝包虫囊肿与多次腹腔定位的关联并不常见。选择的治疗是手术，主要通过开放手术进行。由于在混合肝和腹内包虫病的治疗中采用了独特的腹腔镜方法，因此该病例是独特的。
