Abdominisation of fibrous capsule cavity in the treatment of liver echinococcosis

Aim. To present the treatment results of patients with liver echinococcosis using abdominisation method to eliminate the fibrous capsule cavity.

Methods. Method of fibrous capsule abdominisation was used in 73 patients with liver echinococcosis. Primary echinococcosis was diagnosed in 68 patients, relapse - in 5. An important condition for the surgery success is a thorough examination of the residual capsule to detect biliary fistulas and in case of their presense - a reliable suturing of the fistula with the subsequent control of their hermeticity and drainage. The fibrous capsule cavity and subphrenic space were drained using fascines drainage through which the fibrous capsule cavity was irrigated with ozonated sodium chloride solution and 0.02% dekasan solution.

Results.. Postoperative complications occurred in 4 patients, and were presented with bile leakage, pleuritis and wound infection. There were no fatal cases. During the course of treatment biochemical tests results of patients who underwent fibrous capsule abdominisation, and patients in whom the fibrous capsule elimination was performed by capitonnage and intussusception were compared. The best results were found in patients with fibrous capsule abdominisation. Abdominisation method is reasonable for cysts of medium and large sizes (up to 15 cm in diameter), and in cases when the cavity elimination has a risk of blood vessels and bile ducts damage.

Conclusion. Our research showed the possibility to perform fibrous capsule cavity abdominisation in liver echinococcosis, this method does not worsen liver functional state compared with capitonnage and intussusception.