Analysis Of Diagnosis And Treatment Of End-stage Hepatic Alveolar Echinococcosis Combined With Obstructive Jaundice

Objective:Investigate the treatment methods and efficacy of end-stage hepatic alveolar echinococcosis combined with obstructive jaundice.Methods:Retrospective analysis for diagnosis and treatment of55cases with end-stage hepatic alveolar echinococcosis combined with obstructive jaundice of clinical data from January2000to January2013in the first affiliated hospital of xinjiang medical university. Grouped according to the different treatment options,group A:palliative surgery group(palliative lesion resection and biliary decompression surgery group)include38cases(69.1%)and group B:interventional group(percutaneous transhepatic cholangial drainage,namely PTCD group)include17cases(30.9%).The study compared the two groups’general data、preoperative and postoperative3-7days of liver function operation tim、blood loss、the average hospital stay、postoperative time with the abscess cavity drainage tube、lesions continued to invade and/or metastasize、biliary complication (postoperative biliary fistula、cholangitis、complicated with recurrent obstructive jaundice)、mortality、the cumulative survival rate、survival curve and so on.T-test or t’-test was used to analyze the measurement data and chi-square test was used to analyze the count data.Parallel log rank test and kaplan-meier method was used to calculate the survival rate in survival analysis.Results:A group of operative time、blood loss、the average hospital stay were significantly higher than that of group B(P<0.05),and postoperative total bilirubin、direct bilirubin、r-glutamyl transpeptidase、alkaline phosphatase did not decline significantly in group B(P<0.05),moreover A group of postoperative aspartate aminotransferase、 alanine aminotransferase、albumin damage level were significantly serious than that of group B(P<0.05).Comparing the two groups’(A and B)general data(gender、age、 nation)、preoperative liver function、postoperative time with the abscess cavity drainage tube、lesions continued to invade and/or metastasize、biliary complication、mortality、 the cumulative survival rate、survival curve:the difference was not statistically significant (P>0.05).Conclusion:Interventional treatment is an effective treatment for end-stage hepatic alveolar echinococcosis combined with obstructive jaundice,it has the advantages of minimally invasive、simple、safe、repeatability and so on and can replace the traditional palliative surgery. Simultaneously,it can buy time for such patients in liver transplantion or even creat opportunities for radical hepatectomy.