肝包虫病术后复发及再手术的临床分析

Clinical analysis of reoperation and recurrence in after operation for hepatic hydatid disease

目的 探讨肝包虫病术后复发的原因以及再手术的有关问题。方法 对我院1980～1999年所收治的18例肝包虫病术后复发的病人作一回顾性分析。结果 复发病人18例,复发时间4～19年,平均8.2年。复发部位发生在肝2例,脾区、大网膜、肠系膜3例,肝区脾区、大网膜、肠系膜、前、后壁腹膜、盆腔腹膜13例。再手术17例痊愈,1例死亡。结论 肝包虫病第1次手术中的失误是术后复发的直接原因。对复发的病人应积极地再手术,充分的术前准备,良好的术野显露及针对不同部位、不同大小的复发性包虫囊肿所采取不同的手术方式是再手术成功的关键。

Obejective To discuss the reason of recurrence after operation for patient with hepatic hydatid disease and some problems of reoperation. Methods 18 patient with recurrence after operation from 1980 to 1999 were analysed retrospectively.Results 18 recurrent patient was reopertied.the recurrent time of postoperation was 4-19 years.mean time was 8.2 years. The recurrent.occurred at the liver 2 cases,spleen area 、omentum、 mesentery 3 cases,around the liver、parietal peritoneum 13 cases. 17 patient was recoveried. 1 patiem died. Conclusion The misplay in first operation is the important reason lead to recurrent. It is important to reoperate fully preoperative preparation. fully operative exhibition and the appropriate choice of operation proce- dure on different position. different size and fifferent patient.