Organ-sparing resection techniques in the treatment of liver echinococcosis

This study aims to present and evaluate the results of treating surgery patients using organsparing resection interventions for liver echinococcosis.

Material and methods. The study presents the results of treating 103 patients (51/49.6 % males, 52/50.6 % females) who have undergone total radical pericystectomy/atypical liver resection for liver echinococcosis. Patients were divided into two groups: Group 1, with interventions performed through laparotomic access (n = 84), and Group 2, with interventions using laparoscopic techniques (n = 19).

Results. In the abdominal intervention group, there was no statistically significant advantage in the rate of parenchyma dissection between different methods (p > 0.05). The average time of haemostasis without the Tachocomb haemostatic substance applied showed a lower value (p = 0.17). The average blood loss during the Pringle manoeuvre was significantly lower (p = 0.043).

There was no statistically significant advantage in the laparoscopic intervention group as regards the rate of parenchyma dissection (p = 0.74). The average haemostasis time was significantly shorter in patients using the Floseal haemostatic matrix than those treated otherwise (p = 0.001). In patients with the improved laparoscopic Pringle manoeuvre, blood loss was significantly less than in those who had not undergone the technique (p = 0.00008).

No statistically significant differences were observed (p = 0.76) when comparing the percentages of nonspecific complications in the two groups. The average value of postoperative bed-day was significantly lower in the laparoscopic surgical treatment group (p = 0.00001).

Conclusion. Using the Pringle maneuver when performing abdominal and laparoscopic interventions statistically proved its effectiveness. The use of the Floseal haemostatic matrix during laparoscopic operations allowed a statistically significant reduction in the time of haemostasis and intraoperative bleeding. The duration of the operation and the time of dissection of the parenchyma in the laparoscopic surgery were significantly higher (p < 0.05). The immediate results of the laparoscopic and abdominal interventions proved comparable.

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