TISSUE SPARING TECHNIQUE IN LIVER HYDATID DISEASES: THREE-WAY TECHNIQUE VERSUS HYDATID CONE TECHNIQUE

Document Type : Original Article

Authors

1 Consultant of General Surgery, Military Medical Academy, Cairo, 11291

2 Parasitolgy Department, Faculty of Medicine, Ain Shams University, Cairo 11566

Abstract

Echinococcosis (known as hydatid disease or hydatidosis) is a serious, sometimes fatal, zoonotic
disease caused by Echinococcus two species. E. granulosus, causes worldwide cystic echinococcosis
(hydatidosis) maintained in domestic transmission cycle involving dogs and livestock
mainly sheep, and E. multilocularis, causes alveolar echinoccososis endemic in the northern hemisphere
in wild transmission cycle involving dogs and wild carnivores and rodents. Intermediate
hosts including man are infected by ingestion of eggs dropped from dog with food, fluid
or fingers, or by crawling insects from site of fecal deposition. Eggs hatch in gut into invasive
oncospheres, which penetrate intestinal mucosa, enter venous and lymphatic pathways. These
oncospheres according to species developed into unilocular or classical hydatid disease or cystic
echinococcosis, with few years’ incubation period or infiltration into alveolar or multilocular
echinoccososis with 10-30 years incubation period. The clinical pictures of E. granulosus were
usually from asymptomatic to fatal. But, alveolar echinoccososis particularly in the liver becomes
metastatic and is frequently fatal. Chemotherapies (albendazole, mebendazole or praziquantil)
may be of value prior to surgery or in inoperable cases, but alveolar cysts may require both
surgery and prolonged chemotherapeutic treatment.
Liver surgery has gone through the phases of wedge liver resection, regular resection of heaptic
lobes, irregular and local resection, extracorporeal hepatectomy, hemi-extracorporeal hepatectomy
and others. Taking the modern technologies advantage, the liver surgery is stepping into
an age of precise liver resection.

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