肝包囊-消化吻合术:指征、结果和手术决策算法。

IF 0.8 Q4 SURGERY
Chirurgia Pub Date : 2025-08-01 DOI:10.21614/chirurgia.3159
Stere Popescu, Tina Popescu, Bogdan Obada, Teodor Ștefan Niţu, Irina Niţu, Maria Sabina Neacşu, Ana Maria Grigorescu, Florin Gabriel Pănculescu, Florin Daniel Enache, Mihai Victor Lupaşcu, Iulian Manac, Daniel Ovidiu Costea
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引用次数: 0

摘要

摘要包囊-消化吻合术是一种少见但有价值的治疗复杂肝包囊的手术方法。材料和方法:本回顾性观察性研究包括罗马尼亚一家普外科中心2010年至2023年间接受手术的24例患者。我们分析术中决策、吻合方式和术后结果。结果:Roux-en-Y空肠造口术19例,胃周造口术5例。所有患者术中均确诊胆道瘘Ãⅱ?¥5毫米。没有死亡或再干预。轻微并发症包括短暂性发热综合征(12.5%),肠道转运延迟(8.3%)和一次经皮引流肝下收集(4.1%)。随访影像显示所有病例的残余腔逐渐减少。结论:当指征正确时,包囊-消化吻合术可为大的、位于中心位置的有胆道瘘的囊肿和组织良好的包囊提供安全有效的内引流。根据临床经验和现有文献,我们提出了一种实用的决策算法来指导复杂肝包虫病的手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pericystic-Digestive Anastomosis for Hepatic Hydatid Cysts: Indications, Outcomes, and a Surgical Decision Algorithm.

Introduction: Pericystic-digestive anastomosis is a rarely used but valuable surgical option in the management of complicated hepatic hydatid cysts. Materials and Methods: This retrospective observational study included 24 patients operated on between 2010 and 2023 in a general surgery center in Romania. We analyzed intraoperative decision-making, type of anastomosis, and postoperative outcomes. Results: Roux-en-Y jejunostomy was performed in 19 patients, and pericystogastrostomy in 5. All patients had intraoperatively confirmed biliary fistulas â?¥5 mm. There were no deaths or reinterventions. Minor complications included transient febrile syndrome (12.5%), delayed bowel transit (8.3%), and one percutaneously drained subhepatic collection (4.1%). Follow-up imaging showed progressive reduction of residual cavities in all cases. Conclusions: When correctly indicated, pericystic-digestive anastomosis provides safe and effective internal drainage for large, centrally located cysts with biliary fistulas and well-organized pericysts. Based on clinical experience and current literature, we propose a practical decision-making algorithm to guide surgical management in complicated hepatic echinococcosis.

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来源期刊
Chirurgia
Chirurgia Medicine-Surgery
CiteScore
1.00
自引率
0.00%
发文量
75
审稿时长
4-8 weeks
期刊介绍: Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither appeared, nor were sent for publication in other periodicals, can be published. You can send original articles, new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and, depending on publication space, - reviews of some articles of general interest to surgeons from other publications. Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and participation notes in other scientific meetings. Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please submit these letters to the editor through our online system.
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