[Intrahepatic cholangiojejunostomy on the third segment in non-operable neoplasms of the hepatic hilum]. / La colangiodigiunostomia intraepatica al III segmento nelle neoplasie inoperabili dell'ilo epatico.

The authors report their experience in 19 cases of primitive or secondary tumor of the hilus of the liver which couldn't benefit from radical operation. Palliative treatments--to resolve the jaundice (which is often the only responsible for a short-term exitus)--include surgical (intrahepatic bilio-digestive derivations) and non surgical procedures (PTDB, percutaneous transtumoral intubation). Considering the ephemeral results of the latter, the Authors take peripheral derivative operations into account and particularly the Soupault and Couinaud technique (intrahepatic colangiojejunostomy) performed in 7 patients with satisfying results. It is an easy and quick technique--because of constant anatomical situation of the left intrahepatic biliary distribution and of the superficial location of the duct of the III segment--which allows a lasting biliary decompression with a good residual life.

[The rationale in surgery of hepatic echinococcosis: total pericystectomy and resections. Personal experience]. / Il "razionale" nella chirurgia della echinococcosi epatica: la pericistectomia totale e le resezioni. Esperienza personale.

The Authors report their fifteen years experience in the surgical treatment of hepatic hydatid cysts. They emphasize the difference in the incidence of radical procedures (pericystectomy and hepatic resections) registered in the two periods examined (1980-83 and 1987-93), stressing the role of current diagnostic imaging techniques and improved surgical procedures which allow to perform standard operations for a radical treatment of hepatic hydatid cysts. Total pericystectomy is considered the procedure of choice; rarely it can't be performed (high vascular risk in central cysts located between portal and hepatic veins) and consequently subtotal pericystectomy or conservative treatment are the only possible procedures. Hepatic resection is preferred in case of multiple cysts involving the same lobe or when a giant hydatid cyst replaces the lobe. A further therapeutical resource--in radical procedures--is offered by the use of antihelminth drugs with marked antiparasitic action (albendazole).