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Clinical Outcome and Immune Follow-Up of Different Surgical Approaches for Human Cyst Hydatid Disease in Liver

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  • Department of Hepatobiliary Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Department of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan Shandong, China; Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China

A new surgical approach (subadventitial cystectomy) has been developed for liver hydatid disease. We retrospectively compared clinical outcomes and immune status 24 months after a subadventitial cystectomy with traditional surgical approaches. Patients with liver hydatid cysts were treated with a subadventitial cystectomy (N = 11), pericystectomy (N = 16), partial pericystectomy (N = 18), or hepatic resection (N = 12). By the end of the follow-up period, the subadventitial cystectomy group had the fewest post-operative complications and shortest hospital stays. Two recurrences occurred: one recurrence after partial pericystectomy and one recurrence after pericystectomy. The total immunoglobulin E (IgE) level decreased significantly in the subadventitial cystectomy group. The post-surgery IgG level was lower in the subadventitial cystectomy than the pericystectomy and partial pericystectomy groups. In conclusion, subadventitial cystectomy completely removes the parasite, causing lower complication rates and lower immune reactions.

Author Notes

* Address correspondence to Hao Wen, State Key Laboratory Incubation Base of Xinjiang Major Diseases Research (2010DS890298) and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China. E-mail: wenhao@superinfo.info

Financial support: This research is supported by National Natural Science Foundation of China Grants 81372425 and U1303222, Program for Changjiang Scholars and Innovative Research Team in Universities IRT1181, Zhejiang Medical Research Funding Grant LY13H180003, and Xinjiang Science and Technology Bureau Project 2013911131.

Authors' addresses: Xinhua Chen, Department of Hepatobiliary Surgery, The First Affilated Hospital of Zhejiang University, Hangzhou, China, E-mail: xinhua_chen@zju.edu.cn. Xinmei Chen, Department of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China, E-mail: xinmeichen@126.com. Yinmei Shao, Jingming Zhao, Haitao Li, and Hao Wen, Department of Surgery, Xinjiang Medical University, Urumqi, China, E-mails: syingmei3000@163.com, zixiu123@sina.com, lht45182@163.com, and Dr.wenhao@163.com.

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