切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2025, Vol. 19 ›› Issue (02) : 119 -123. doi: 10.3877/cma.j.issn.1674-0793.2025.02.010

综述

肝细粒棘球蚴病胆道并发症的研究进展
祖米来提·波拉提1, 胡雪源1, 郭强1,2, 蒋铁民1,2,()   
  1. 1. 830054 乌鲁木齐,新疆医科大学第一附属医院消化血管外科中心肝胆包虫病外科
    2. 830054 乌鲁木齐,新疆医科大学省部共建中亚高发病成因与防治国家重点实验室
  • 收稿日期:2024-10-21 出版日期:2025-04-01
  • 通信作者: 蒋铁民
  • 基金资助:
    省部共建中亚高发病成因与防治国家重点实验室开放课题基金项目(SKL-HIDCA-2024-22)中央引导地方科技发展专项资金项目(ZYYD2022B06)

Research progress of biliary complications of hepatic cystic echinococcosis

Bolati Zumilaiti1, Xueyuan Hu1, Qiang Guo1,2, Tiemin Jiang1,2,()   

  1. 1. Department of Hepatobiliary & Hydatid Disease, Digestive &Vascular Surgery Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
    2. State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi 830054, China
  • Received:2024-10-21 Published:2025-04-01
  • Corresponding author: Tiemin Jiang
引用本文:

祖米来提·波拉提, 胡雪源, 郭强, 蒋铁民. 肝细粒棘球蚴病胆道并发症的研究进展[J/OL]. 中华普通外科学文献(电子版), 2025, 19(02): 119-123.

Bolati Zumilaiti, Xueyuan Hu, Qiang Guo, Tiemin Jiang. Research progress of biliary complications of hepatic cystic echinococcosis[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2025, 19(02): 119-123.

肝细粒棘球蚴病(HCE)破入胆道引起的胆道并发症是最为常见且严重的并发症之一,主要通过其临床表现结合影像学检查来明确诊断。外科手术是HCE破入胆道最有效的治疗方法,需要在根治性手术或保守手术的基础上合理实现胆道减压、清除胆道内囊性物质,保持胆道通畅。合理处理术后并发症时,胆总管探查T管引流术较为常用,并在瘘管和胆道内放置双T管减压引流,内镜逆行胰胆管造影术(ERCP)作为HCE破入胆道的一种术前及术后重要技术,可有效清除破入胆道的内容物,解除胆道梗阻,进一步降低感染风险。本文从HCE胆道并发症的临床表现、诊断、治疗等方面进行综述,以期通过早期发现、诊断并处理影响其发生的因素,从而改善患者的预后。

Biliary complication caused by hepatic cystic echinococcosis (HCE) intrabiliary rupture is one of the most common and serious complications of HCE, which is mainly diagnosed by its clinical manifestations and imaging examinations. Surgical treatment is the most effective method for intrabiliary rupture of HCE, which needs to decompress biliary tract, and keep the bile duct unobstructed on the basis of radical surgery or conservative surgery, and reasonably deal with the postoperative complications.Choledochotomy T-tube drainage is more commonly applied nowadays, and double T-tube drainage are placed in the fistula and the biliary tract. Endoscopic retrograde cholangiopancreatography, as an important preoperative and postoperative technique for intrabiliary rupture of HCE, can effectively remove the contents broken into the biliary tract and further reduce infection risk. This article reviews the clinical manifestations,diagnosis, and treatment of biliary complications of HCE, with the aim of improving the prognosis by early detection, diagnosis, and treatment.

[1]
Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: advances in the 21st century[J]. Clin Microbiol Rev, 2019, 32(2): e00075-18.
[2]
Aghajanzadeh M, Ashoobi MT, Hemmati H, et al. Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: A case report[J]. J Med Case Rep, 2021, 15(1): 311.
[3]
Dolay K, Akbulut S. Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease[J]. World J Gastroenterol, 2014, 20(41): 15253-15261.
[4]
Mihmanli M, Idiz UO, Kaya C, et al. Current status of diagnosis and treatment of hepatic echinococcosis[J]. World J Hepatol, 2016,8(28): 1169-1181.
[5]
Faraj W, Abi Faraj C, Kanso M, et al. Hydatid disease of the liver in the Middle East: A single center experience[J]. Surg Infect(Larchmt), 2022, 23(1): 29-34.
[6]
Ufuk F, Duran M. Intrabiliary rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, and septicemia[J]. J Emerg Med, 2018, 54(1): e15-e17.
[7]
Ferrer Inaebnit E, Molina Romero FX, Segura Sampedro JJ, et al.A review of the diagnosis and management of liver hydatid cyst[J].Rev Esp Enferm Dig, 2022, 114(1): 35-41.
[8]
Villán González A, Pérez Pariente JM, Barreiro Alonso E.Obstructive jaundice secondary to a hepatic hydatid cyst[J]. Rev Esp Enferm Dig, 2018, 110(11): 741-742.
[9]
Leeuw D, Van Der Schaar PJ, Zoutendijk R. Biliary obstruction caused by an erupted hepatic hydatid cyst[J]. Endoscopy, 2022,54(3): E98-E99.
[10]
Castillo S, Manterola C, Grande L, et al. Infected hepatic echinococcosis. clinical, therapeutic, and prognostic aspects. A systematic review[J]. Ann Hepatol, 2021, 22: 100237.
[11]
Wani I, Bhat Y, Khan N, et al. Concomitant rupture of hydatid cyst of liver in hepatic duct and gallbladder: case report[J].Gastroenterol Res, 2010, 3(4): 175-179.
[12]
Toumi O, Ammar H, Gupta R, et al. Management of liver hydatid cyst with cystobiliary communication and acute cholangitis: A 27-year experience[J]. Eur J Trauma Emerg Surg, 2019, 45(6): 1115-1119.
[13]
Elmajdoubi H, Elbarkaoui Z, Sebbah F, et al. Rupture of hydatid cyst in the gallbladder leading to acute cholangitis[J]. Case Rep Infect Dis, 2021, 2021: 9858658.
[14]
吐尔干艾力, 邵英梅, 赵晋明, 等. 肝囊型包虫病胆道并发症284例的诊治分析[J]. 中华肝胆外科杂志, 2011, 17(2): 104-109.
[15]
Shalayiadang P, Abulizi A, Ahan A, et al. Diagnosis and treatment modalities of hilar biliary duct stricture in hepatic cystic echinococcosis after endocystectomy[J]. Parasite, 2021, 28: 51.
[16]
Biswas SN, Kulkarni A, Jain M, et al. Intra-biliary rupture of hepatic hydatid cyst: An uncommon presentation of a common disease[J]. Indian J Gastroenterol, 2021, 40(4): 445-447.
[17]
吐尔干艾力·阿吉. 肝两型包虫病不同术式的前瞻性对照研究及并发症处理[D]. 乌鲁木齐: 新疆医科大学, 2011.
[18]
Salvador F, Escolà-Vergé L, Barios M, et al. Usefulness of the FDG PET/CT in the management of cystic echinococcosis: A pilot study[J]. Acta tropica, 2022, 227: 106295.
[19]
Botezatu C, Mastalier B, Patrascu T. Hepatic hydatid cyst-diagnose and treatment algorithm[J]. J Med Life, 2018, 11(3): 203-209.
[20]
Wu M, Yan C, Wang X, et al. Automatic classification of hepatic cystic echinococcosis using ultrasound images and deep learning[J]. J Ultrasound Med, 2022, 41(1): 163-174.
[21]
王佳, 李辉, 马进, 等. CT联合MRCP诊断肝包虫病胆道并发症的价值[J]. 放射学实践, 2020, 35(9): 1132-1137.
[22]
Yu XK, Zhang L, Ma WJ, et al. An overview of hepatic echinococcosis and the characteristic CT and MRI imaging manifestations[J]. Infect Drug Resist, 2021, 14: 4447-4455.
[23]
Abbasi B, Akhavan R, Ghamari Khameneh A, et al. Computed tomography and magnetic resonance imaging of hydatid disease: A pictorial review of uncommon imaging presentations[J]. Heliyon,2021, 7(5): e07086.
[24]
Borahma M, Jebari Y, Chabib FZ, et al. Endoscopic treatment of a liver hydatid cyst with biliary rupture[J]. Endoscopy, 2022, 54(8):E456-E457.
[25]
Dişçi E, Peksöz R, Yıldız M, et al. Endoscopic retrograde cholangiopancreatography in pediatric patients[J]. J Laparoendosc Adv Surg Tech A, 2022, 32(3): 320-324.
[26]
Cantay H, Anuk T. Factors affecting the choice of treatment in hepatic hydatid cyst surgery[J]. J Invest Surg, 2022, 35(4): 731-736.
[27]
Berto CG, Liou P, Coyle CM, et al. Surgical management of cystic echinococcosis of the liver[J]. Curr Opin Infect Dis, 2023, 36(5):348-352.
[28]
Nayar R, Varshney VK, Hussain S, et al. Left hepatectomy for hepatic hydatid cyst with intra-biliary rupture: better to be radical[J]. Med J Armed Forces India, 2023, 79(Suppl 1):S325-S328.
[29]
Al-Saeedi M, Ramouz A, Khajeh E, et al. Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis:A systematic review with single-arm meta-analysis[J]. PLoS Negl Trop Dis, 2021, 15(5): e0009365.
[30]
Erzurumlu K, Dervisoglu A, Polat C, et al. Intrabiliary rupture: An algorithm in the treatment of controversial complication of hepatic hydatidosis[J]. World J Gastroenterol, 2005, 11(16): 2472-2476.
[31]
Sharma BC, Reddy RS, Garg V. Endoscopic management of hepatic hydatid cyst with biliary communication[J]. Digest Endosc,2012, 24(4): 267-270.
[32]
Jiang T, Wang Z, Aji T, et al. ERCP management of acute cholangitis caused by rupture of Echinococcus hepaticus into the biliary tract[J]. J Minim Access Surg, 2023, 19(4): 498-503.
[33]
Stojkovic M, Junghanss T, Veeser M, et al. Endoscopic treatment of biliary stenosis in patients with alveolar echinococcosis--report of 7 consecutive patients with serial ERC approach[J]. PLoS Negl Trop Dis, 2016, 10(2): e0004278.
[34]
Zhang H, Yang J, Li J, et al. An integrated surgical training program for hepatic cystic echinococcosis in Xinjiang of China[J].PLoS Negl Trop Dis, 2020, 14(3): e0008023.
[35]
Pösteki G. Gallbladder hydatid disease complicated with multiple hepatobiliopancreatic fistulae: A case report[J]. Iran J Parasitol,2023, 18(3): 414-418.
[36]
艾尼娃尔·艾克拜. 分期ERCP和手术与一期手术治疗肝囊型包虫破入胆道临床疗效分析[D]. 乌鲁木齐: 新疆医科大学, 2024.
[1] 张大山, 李贺鹏, 蒋福林, 商中华. 代谢功能障碍与免疫微环境关系在肝细胞癌发生发展的作用机制[J/OL]. 中华普通外科学文献(电子版), 2025, 19(02): 124-129.
[2] 沈锋, 王葵, 刘建伟. 我国腹腔镜肝癌手术治疗现状、问题与发展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 237-240.
[3] 蔡建强, 毕新宇, 徐博文. 我国腹腔镜肝癌手术的难点与对策[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 241-244.
[4] 王占奎, 陈治远, 孙闻晖, 杨庆玲, 杨小斌. 术前免疫炎症指数及AFU水平对肝癌患者介入术后早期复发的预测研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 247-250.
[5] 钱小梅, 罗洪, 李智慧, 周代君, 李东. 76例乙型肝炎肝硬化并发原发性肝癌的高危因素Logistic分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 251-253.
[6] 卢超, 陈波, 邢志祥, 周鹏, 王帅. 不同入路下腹腔镜解剖性肝脏切除术治疗肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 254-257.
[7] 盛海涛, 窦明睿, 王俊杰, 修小龙, 杨建茂, 董长城. 基于CT三维可视化技术的个体化肝分段在解剖性肝切除术中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 258-261.
[8] 张小松, 马俊永, 李锡锋, 施乐华, 沈锋. 腹腔镜鞘内解剖性右半肝切除联合区域淋巴结清扫[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(03): 245-245.
[9] 张伟, 尚丹丹, 尚培中, 李晓武, 苗建军, 刘冰. 腹腔镜术中应用壶腹钟表定位法和胆囊废弃术治疗80岁以上急性胆囊炎[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 188-191.
[10] 齐普良, 孙凯华, 任军帮, 马丽娜, 李彩霞, 田青山. 微创取纱垫在高原地区肝破裂二期术中的应用研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 196-199.
[11] 潘银珍, 张秀玉, 麦燕桃, 梁智强. 两种术式治疗肝内胆管细胞癌的临床疗效研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(02): 208-211.
[12] 汪洋, 张楠, 杨伟锋, 何海填, 王可兵. 原发性肾血管肉瘤并出血一例报告并文献复习[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(02): 248-249.
[13] 张海雄, 吴显博, 罗发. 腹腔镜荧光正染S7段肝切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(03): 508-508.
[14] . 腹腔镜左半肝切除+胆囊切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(03): 509-509.
[15] 于毅. “指捏法切肝”治疗严重肝外伤[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(03): 507-507.
阅读次数
全文


摘要