Modern tactics of surgical treatment of liver echinococcosis

The results of the treatment of 609 patients with liver echinococcosis who underwent various surgical interventions at A.V. Vishnevsky National Medical Research Center of Surgery in the period from 1976 to 2018. The analyzed group included 359 (58,9 %) patients, data on the surgical treatment of which were given in the work published in 2010 (period 1976-2010), as well as 250 (41,1 %) patients treated further between 2010-2018. Of 609 patients with echinococcosis of the liver in the period from 1976 to 2018 open operations were performed in 557 (91,4 %). At the same time, radical operations accompanied by complete removal of the fibrous capsule were used in 252 (45,2 %) patients. Conditionally radical operations, in which the fibrous capsule was removed almost completely, but their small parts, closely adjacent to large intrahepatic vessels and ducts (called subtotal pericystectomy, supplemented by indications of atypical resections), were preserved so as not to damage these structures and cause terrible complications - in 160 (28,7 %). The group of conditionally radical operations included 67 (12 %) patients after combined operations with multiple echinococcal cysts, in which, due to a difficult approach to cysts and the possibility of damage to intrahepatic structures with the development of serious complications, complete or partial excision of fibrous capsules with palliative options was combined echinococcectomy.