SELECTION OF TACTICS IN SURGICAL TREATMENT OF LIVER ECHINOCOCCOSIS

Abstract

To improve the results of treatment of liver echinococcosis by improving surgical tactics using miniinvasive
technologies. Materials and Methods: From 2013 to 2018, in the surgical department of the Urgench regional
multidisciplinary medical center, 257 patients with liver echinococcosis were hospitalized. Surgical interventions were
performed in 235 patients. Patients with combined echinococcosis of the liver and lungs were operated on in two stages.
Digital material processed by the method of variation statistics. Results: Surgical treatment of residual echinococcosis
of the liver differs from the primary treatment in greater trauma, postoperative complications were noted in 11.4%. This
is due to the predominance of inflammatory and dystrophic changes in the fibrous membrane in residual echinococcosis,
which require an increase in the volume of pericystectomy, as well as a predominance of extrahepatic abdominal cysts.
Total pericystectomy significantly increased intraoperative blood loss in both primary and residual echinococcosis of the
liver. During the early postoperative period, a sign of early postoperative intestinal obstruction was observed in 2% of
patients, with repeated surgery, diffuse bleeding was detected. In 6 patients, external bile leakage was noted through the
drainage tubes of the residual cavity. Suppuration of postoperative wounds was observed in 2 patients. Lethal outcomes
were registered in 1.7% of cases. Recurrence of the disease was 7.7%. Conclusion: Radical surgical treatment of primary
and residual liver echinococcosis allows in most cases to achieve good results. For uncomplicated cysts without daughter
blisters, puncture-drainage methods are effective. The use of these treatments for centrally located cysts needs evaluation