Surgical treatment for compression of inferior vena cava by hepatic hydatid cyst / 中华消化外科杂志

ABSTRACT

Objective:To investigate the surgical treatment for compression of inferior vena cava (IVC) by hepatic hydatid cyst.Methods:The retrospective and descriptive study was conducted. The clinical data of 10 patients with hepatic hydatid cyst compressing inferior vena cava who were admitted to the First Affiliated Hospital of School of Medicine of Shihezi University from May 2013 to May 2018 were collected. There were 7 males and 3 females, aged (46±5)years, with a range from 38 to 51 years. Patients underwent subadventitial close total pericystectomy, subadven-titial partial pericystectomy or subadventitial close total pericystectomy with partial IVC resection according to the relative distance between hepatic hydatid cyst and IVC, and the feasibility of total pericystectomy. Observation indicators (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination or telephone interview. Patients were followed up at the outpatient department at postoperative 3, 6, 12, 24 months using color Doppler ultrasound examination to detect the recurrence of hepatic hydatid cyst and inferior vena cava occlusion. The endpoint of follow-up was 2 years after operation, and the secondary endpoint of follow-up was recurrence of hepatic hydatid cyst. The follow-up time was up to May 2020. Measure-ment data with normal distribution were represent as Mean±SD, and count data were described as absolute numbers. Results:(1) Surgical situations 10 patients underwent surgery successfully without massive hemorrhage and septic shock during the operation, including 7 patients undergoing subadventitial close total pericystectomy, 2 patients undergoing subadventitial partial pericys-tectomy, and 1 patient undergoing subadventitial close total pericystectomy with partial IVC resection. The operation time and volume of intraoperative blood loss of 10 patients were (99±27)minutes and (99±48)mL, respectively. (2) Postoperative situations the time to drainage tube removal and duration of postoperative hospital stay of 10 patients were 2-5 days and (7.1±1.8)days. None of patients underwent postoperative bleeding, residual cavity infection, biliary fistula, or perioperative death. (3) Follow-up of 10 patients, 9 patients completed the endpoint of follow-up and no recurrence of hepatic hydatid cyst or inferior vena cava occlusion formation was detected. The other 1 patient was followed up at postoperative 3, 6 months but failed to be followed up at postoperative 12 months, and no recurrence of hepatic hydatid cyst or inferior vena cava occlusion formation was detected during the follow-up time.Conclusion:Complete resection of hepatic hydatid cyst can be achieved by subadventitial close total pericystectomy, subadventitial partial pericystectomy or subadventitial close total pericystectomy with partial IVC resection.