Safra yollari zedelenmesi ile seyreden karaciger hidatozunun teshisi ve cerrahi tedavisinin özellikleri*
Peculiarities of diagnostic and surgical treatment of liver echinococcosis with affection of bile ducts
- Ana Sayfa
- Sayılar
- Safra yollari zedelenmesi ile seyreden karaciger hidatozunun teshisi ve cerrahi tedavisinin özellikleri*...
Özet
Giris ve amaç: Karaciger kist hidatid enfeksiyonu koyun, sigir yerlestiren bölgelerden görülen önemli bir saglik problemidir. Cerrahi yaklasim, karaciger kist hidatid tedavisinde geleneksel bir yaklasimdir. Kist hidatid cerrahisi önemli ölçüde morbidite ve mortalite oranina sahiptir. Bu çalisma, kist hidatid nedeniyle opere olan biliyer sistem hasarli hastalari degerlendirmek amaciyla planlanmistir. Gereç ve yöntem: Cerrahi tedavi olan toplam 277 kist hidatidli hasta (erkek/kadin, 122/155; ortalama yas, 40.3 yil (aralik: 9-82 yil) çalismaya alindi. Hastalarin hepsinde biliyer sistemde hasari bulunmaktaydi. Biliyer sistem hasarinin tanisi klinik, byokimyasal ve görüntüleme yöntemleri konuldu. Bulgular: Hidatid kist cerrahisi sonrasi biliyer sistem hasari olan 277 hastanin %56’sina (155) safra yollari hasarinin tamiri için kistektomi operasyonu yapildi. Postoperatif dönemde hastalarin %26’sinda morbidite ve %1.4’ünde mortalite gözlendi. Kist apsesi en sik görülen post-operatif komplikasyon idi. Sonuç: Biliyer sistem hasari, kist hidatid cerrahisinden sonra sik görülen önemli komplikasyondur. Ikincil bir cerrahi yaklasimla bu komplikasyon tedavi edilebilir. Tedavinin basarisi kist lokalizasyonu, kist sayisi ve biliyer hasarin derecesi ile iliskilidir.
Abstract
Background and aims: Hydatid cyst of the liver is a common health problem in sheep- and cattle-raising areas. Traditionally, surgery has been a reasonable treatment modality; however, it has a high morbidity and mortality rate. The aim of this study was to investigate the post-operative complications of surgical therapy of hydatid cysts of the liver with biliary tract injury. Materials and methods: A total of 277 patients with hydatid cysts (male/female, 122/155; average age, 40.3 years, range: 9- 82 years) who underwent hydatid surgery were enrolled. All patients had biliary tract injury after surgery. Biliary tract injury was diagnosed by clinical, biochemical and radiological (sonography, tomography, ERCP) methods. Results: Among the 277 individuals with hydatid cysts who had biliary tract injury after surgical treatment, 155 individuals (56%) had cystectomy for repairing bile duct fistula. Post-operative morbidity and mortality were 26% and 1.4%, respectively. Cyst abscess was the most common post-operative complication. Conclusion: Biliary tract complication after hydatid surgery is an important and commonly seen problem. Such a complication is treatable with second surgical management. Success in such surgery is related with cyst localization, cyst number and the extent of biliary tract injury.
