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The paper report a case of postoperative recurrent hydatid disease in a fifty-year-old man. The scarcity of published works on the etiological causes of this pathology and the lack of an uniform treatment protocol necessitate a correct and radical surgical approach. The patient underwent cystopericystectomy and after three months follow-up is still free of disease.
A comparative assessment of different methods of angiography for diagnostics of echinococcosis of the liver is given. Conditions of prolonged contrast of vessels and parenchyma of the organ were created by splenoportography and arteriography of the liver with maiodyl which allows to determine the presence and degree of morphofunctional changes and spread of the pathological process in echinococcosis of the liver.
The authors analyse the results of intraoperative ultrasonic examination (IOUSE) of the liver in 31 patients with echinococcosis of the liver; 21 of them had multiple hydatid cysts in the liver. The authors came to the conclusion that IOUSE is a highly informative method for noninvasive diagnosis in surgery of the liver. IOUSE is indicated when information must be obtained during the operation concerning the location of invisible and nonpalpable pathological structures, the borderlines of their extension, the anatomical relations with the vascular-ductal structures of the liver. Exact echographic localization of these structures and their grading ensure safety of various types of operations in this disease.
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The humoral immunity and the protein-synthesizing function of the liver of 35 patients with liver echinococcosis were studied. No humoral immunity deficit was found. Statistically significant abnormalities in a number of proteins were reduced, with evidence of reduced protein-synthesizing liver function. Inferences are made on the anesthesia, resuscitation and operative interventions, in connection with the results of the study.
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In 72 patients with hydatid disease results and complications of different operation techniques are compared. Whereas we previously preferred pericystectomy and resecting methods we now perform irrigation and drainage in hydatid cysts of the liver. By use of a simple, flexible instrument even poorly accessible cysts can be transferred to irrigation and drainage therapy. Results of this procedure are good. The complication rate was decreased.
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Systematic histological investigations concerning the existence of protoscolices in the fibrotic capsula and in the liver parenchyma of operated patients were carried out by means of the immuno-fluorescence. A protoscolex in the fibrotic capsula was detectable histologically only once. The theory of Napalkov about the relapses of the disease by protoscolices invaded in the fibrotic capsula and surrounded tissue cannot be corroborated after the transplantation of fibrotic capsula in white mice before and after sterilisation by Scolicid and the other investigations. A method for sterilisation of the fibrotic cavity and the fibrotic capsula is presented. In that way difficult traumatising operations with high lethality like pericystectomy and resection of the liver are avoidable.
Echotomography was used in the complex examination of 84 patients operated upon for echinococcosis of the liver. An analysis of the data obtained has shown echotomography to be highly sensitive in patients with cavital newformations. The method is expedient to be used first in the complex examination of patients with any pathology of the liver for the detection of patients with echinococcus disease, for the establishment of the topographic localization and recurrences of the pathological process.
Laser was used in 14 patients for the treatment of surface of the residual cavity after excision of Echinococcosis cysts. The author notes positive sides of this method.
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