PDF(Pubmed)
Abstract：
Cystic echinococcosis is a zoonotic parasitic disease that affects the liver in more than 70% of cases, and there is still an underestimated incidence in endemic areas. With a peculiar clinical presentation that ranges from paucisymptomatic illness to severe and possibly fatal complications, quality imaging and serological studies are required for diagnosis. The mainstay of treatment to date is surgery combined with antiparasitic agents. The surgical armamentarium consists of open and laparoscopic procedures for selected cases with growing confidence in parenchyma-sparing interventions. Endoscopic retrograde cholangiopancreatography (ERCP) is extremely useful for the diagnosis and treatment of biliary fistulas. Recent relevant studies in the literature are reviewed, and two complex cases are presented. The first patient underwent open surgery to treat 11 liver cysts, and during the follow-up, a right pulmonary cyst was diagnosed that was treated by minimally invasive surgery. The second case is represented by the peritoneal rupture of a giant liver cyst in a young woman who underwent laparoscopic surgery. Both patients developed biliary fistulas that were managed by ERCP. Both patients exhibited a non-specific clinical presentation and underwent several surgical procedures combined with antiparasitic agents, highlighting the necessity of customized treatment in order to decrease complications and successfully cure the disease.
摘要：
囊性包虫病是一种人畜共患寄生虫病，在超过70％的病例中影响肝脏，流行地区的发病率仍然被低估。具有特殊的临床表现，从无症状的疾病到严重的甚至致命的并发症，诊断需要高质量的影像学和血清学研究。迄今为止的主要治疗方法是手术联合抗寄生虫药。外科医疗设备包括针对某些病例的开放式和腹腔镜手术，对保留实质的干预措施越来越有信心。内镜逆行胰胆管造影术（ERCP）对于胆道瘘的诊断和治疗非常有用。回顾了文献中最近的相关研究，并提出了两个复杂的案例。首例患者接受开放性手术治疗11例肝囊肿,在后续行动中,诊断为右肺囊肿，经微创手术治疗。第二例是一名接受腹腔镜手术的年轻妇女的巨大肝囊肿的腹膜破裂。两名患者均出现胆瘘，并由ERCP管理。两名患者均表现出非特异性临床表现，并接受了几次手术联合抗寄生虫药，强调定制治疗的必要性，以减少并发症和成功治愈疾病。
