PubMed · 14249671
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S S KULIUKIN. [SPLENIC ECHINOCOCCCOSIS].. https://pubmed.ncbi.nlm.nih.gov/14249671/
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BACKGROUND: The aim of this retrospective study was to evaluate clinical presentation and long-term outcome of patients treated surgically for complicated liver hydatid cysts. PATIENTS AND METHODS: Eighty-four patients with liver hydatid cysts underwent an operation at the Geneva University Hospital between 1980 and 1999. Clinical presentation, postoperative morbidity, mortality, and long-term recurrence rate were evaluated. RESULTS: Among the 84 patients with liver hydatid disease, 35 patients (41%) presented complicated cysts (ie, cysts that had developed a fistula into adjacent structures or organs). In most patients, the fistula communicated with the biliary tree (n = 25), but we also observed communication with the right lung (n = 3), the right diaphragm (n = 2), liver parenchyma (n = 1), and peritoneal cavity (n = 1). Complete removal of the cystic disease was possible in 24 of 35 patients (70%). In 11 patients, fragments of cysts were not removed because of their location adjacent to main vessels. Postoperatively, 8 patients (23%) developed a severe complication (grade II and III). There were no postoperative deaths, and no recurrences of hydatid disease were observed with a median follow-up of 8.6 years (complete follow-up was obtained in 69% of patients). CONCLUSIONS: Complicated liver hydatid disease is frequent and was observed in almost half of patients operated for liver hydatid cysts at our center. Using a surgical strategy aimed at complete removal of cystic and pericystic tissue with simultaneous treatment of the fistulous tract, we observed 23% postoperative morbidity, no mortality, and no recurrence of disease with a median follow-up of >8 years.
OBJECTIVE: To investigate the formative mechanisms of the fibrous capsule around hepatic and splenic hydatid cyst. METHODS: HE stain was used to observe the histopathologic changes of the fibrous capsules around hepatic and splenic hydatid cysts and the adjacent parenchyma. The expression of collagen IV, fibronectin (FN), laminin (LN), transforming growth factor-beta1 (TGF-beta1) and tumor necrosis factor-alpha (TNF-alpha) were detected by using immunohistochemistry or in situ hybridization in fibrous capsules around 40 hepatic hydatid cysts and 15 splenic hydatid cysts including adjacent parenchyma. RESULTS: A special delaminated phenomenon was observed in the fibrous capsules around hepatic hydatid cysts. Granuloma-like pathologic changes were found in the fibrous capsules near worm and there were many depressed Glisson capsules and hepatic vein system in the fibrous capsules near hepatic parenchyma while these phenomena could not be observed in splenic hydatid cysts. All parameters were highly expressed in the fibrous capsules near hepatic parenchyma and the difference between the two fibrous capsules was significant (P<0.01). CONCLUSION: The mechanisms of forming fibrous capsule around hepatic and splenic hydatid cysts are different. The fibrous capsule around hepatic hydatid cyst is a granuloma-like structure, covered by the pressed Glisson system and hepatic vein system with a small gap between them; while the fibrous capsule around splenic hydatid cyst is formed by granuloma-like tissue covering the worm and there is no gap between the capsule and the splenicparenchyma.
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