Background For patients with end-stage hepatic alveolar echinococcosis （AE）, in vivo resection of the involved parts of the liver is usually very difficult, therefore, allogenic liver transplantation is indicated. H...Background For patients with end-stage hepatic alveolar echinococcosis （AE）, in vivo resection of the involved parts of the liver is usually very difficult, therefore, allogenic liver transplantation is indicated. However, we hypothesize that for selected patents, ex vivo liver resection for thorough elimination of the involved tissues and liver autotransplantation may offer a chance for clinical cure. Methods We presented a 24-year-old women with a giant hepatic AE lesion who was treated with hepatectomy, ex vivo resection of the involved tissue and hepatic autotransplantation. The patient had moderate jaundice and advanced hepatic AE lesion which involved segments I, IV, V, VI, VII, VIII and retrohepatic inferior vena cava. The lateral segments （II and III） of the left liver remained normal with over 1000 ml in its volume. No extrahepatic metastases （such as to the lung or brain） could be found. As the first step of treatment, X-ray guided percutaneous transhepatic cholangiodrainage （PTCD） was performed twice for bile drainage in segment III and II separately until her serum total bilirubin decreased gradually from 236 to 88 umol/L. Total liver resection was then performed, followed by extended right hepatic trisegmentectomy and the entire retrohepatic vena cava was surgically removed en bloc while her hemodynamics parameters were stable. Neither veino-veinous bypass nor temporary intracorporeal cavo-caval or porto-caval shunt was used during the 5.7-hour anhepatic phase. The remained AE-free lateral segments of the-left liver were re-implanted in situ. The left hepatic vein was directly anastomosed end-to-end to the suprahepatic inferior vena cava due to the lack of the retrohepatic inferior vena cava with AE total infiltration. Because compensatory retroperitoneal porto-caval collateral circulation developed, we enclosed remained infrahepatic inferior vena cava at renal vein level without any haemodynamics problems. Results During a 60-day following-up after operation, the patient had a good r展开更多
目的:探讨阿苯达唑脂质体(liposom alalbendazole,L-ABZ)及其联合西咪替丁(cim etidine,CTD)治疗小鼠细粒棘球蚴病的病理形态变化。方法:将阿苯达唑脂质体及西咪替丁(1.5% 乳液阿苯达唑200 m g/kg,西咪替丁100 m g/kg),经口灌喂感染小鼠...目的:探讨阿苯达唑脂质体(liposom alalbendazole,L-ABZ)及其联合西咪替丁(cim etidine,CTD)治疗小鼠细粒棘球蚴病的病理形态变化。方法:将阿苯达唑脂质体及西咪替丁(1.5% 乳液阿苯达唑200 m g/kg,西咪替丁100 m g/kg),经口灌喂感染小鼠3个月后,用光镜和电镜观察小鼠肝、腹细粒棘球蚴囊结构的病理改变。结果:以阿苯达唑脂质体联合西咪替丁治疗组细粒棘球蚴囊组织变性坏死改变最为显著,与对照组有显著性差异(P< 0.01)。结论:脂质体包封阿苯达唑,可提高阿苯达唑的抗细粒棘球蚴作用。展开更多
文摘Background For patients with end-stage hepatic alveolar echinococcosis （AE）, in vivo resection of the involved parts of the liver is usually very difficult, therefore, allogenic liver transplantation is indicated. However, we hypothesize that for selected patents, ex vivo liver resection for thorough elimination of the involved tissues and liver autotransplantation may offer a chance for clinical cure. Methods We presented a 24-year-old women with a giant hepatic AE lesion who was treated with hepatectomy, ex vivo resection of the involved tissue and hepatic autotransplantation. The patient had moderate jaundice and advanced hepatic AE lesion which involved segments I, IV, V, VI, VII, VIII and retrohepatic inferior vena cava. The lateral segments （II and III） of the left liver remained normal with over 1000 ml in its volume. No extrahepatic metastases （such as to the lung or brain） could be found. As the first step of treatment, X-ray guided percutaneous transhepatic cholangiodrainage （PTCD） was performed twice for bile drainage in segment III and II separately until her serum total bilirubin decreased gradually from 236 to 88 umol/L. Total liver resection was then performed, followed by extended right hepatic trisegmentectomy and the entire retrohepatic vena cava was surgically removed en bloc while her hemodynamics parameters were stable. Neither veino-veinous bypass nor temporary intracorporeal cavo-caval or porto-caval shunt was used during the 5.7-hour anhepatic phase. The remained AE-free lateral segments of the-left liver were re-implanted in situ. The left hepatic vein was directly anastomosed end-to-end to the suprahepatic inferior vena cava due to the lack of the retrohepatic inferior vena cava with AE total infiltration. Because compensatory retroperitoneal porto-caval collateral circulation developed, we enclosed remained infrahepatic inferior vena cava at renal vein level without any haemodynamics problems. Results During a 60-day following-up after operation, the patient had a good r
文摘目的:探讨阿苯达唑脂质体(liposom alalbendazole,L-ABZ)及其联合西咪替丁(cim etidine,CTD)治疗小鼠细粒棘球蚴病的病理形态变化。方法:将阿苯达唑脂质体及西咪替丁(1.5% 乳液阿苯达唑200 m g/kg,西咪替丁100 m g/kg),经口灌喂感染小鼠3个月后,用光镜和电镜观察小鼠肝、腹细粒棘球蚴囊结构的病理改变。结果:以阿苯达唑脂质体联合西咪替丁治疗组细粒棘球蚴囊组织变性坏死改变最为显著,与对照组有显著性差异(P< 0.01)。结论:脂质体包封阿苯达唑,可提高阿苯达唑的抗细粒棘球蚴作用。
