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Outcomes After Liver Resection for Hepatic Alveolar Echinococcosis: A Single-Center Cohort Study

Joliat, Gaëtan-Romain ; Melloul, Emmanuel ; Petermann, David ; Demartines, Nicolas ; Gillet, Michel ; Uldry, Emilie ; Halkic, Nermin

In: World Journal of Surgery, 2015, vol. 39, no. 10, p. 2529-2534

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    Titre
    • Outcomes After Liver Resection for Hepatic Alveolar Echinococcosis: A Single-Center Cohort Study
    Auteur
    • Joliat, Gaëtan-Romain. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Melloul, Emmanuel. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Petermann, David. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Demartines, Nicolas. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Gillet, Michel. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Uldry, Emilie. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    • Halkic, Nermin. Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • World Journal of Surgery, 2015, vol. 39, no. 10, p. 2529-2534. Springer International Publishing
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331166
    Summary
    Background: Switzerland is a region in which alveolar echinococcosis (AE) is endemic. Studies evaluating outcomes after liver resection (LR) for AE are scarce. The aim of this study was to assess the short- and long-term outcomes of AE patients after LR in a single tertiary referral center. Methods: We retrospectively analyzed data pertaining to all patients with liver AE who were treated with LR at our institution between January 1992 and December 2013. Patient demographics, intraoperative data, extent of LR procedures (major vs. minor LR), postoperative outcomes, and negative histological margin (R0) resection rate were recorded in a database. Recurrence rates after LR were analyzed. Results: LR was performed in 59 patients diagnosed with hepatic AE (56 complete surgeries, 3 reduction surgeries). Postoperative morbidity and mortality were observed in 34% (25% grade I-II, 9% grade III-IV) and 2% of the patients, respectively. R0 (complete) resection rate was 71% (n=42), and R1/R2 resection rate was 29% (n=17). Extra-hepatic recurrence occurred in 1 case (lung) after R0 resection. In cases of R1/R2 resection, 7 intra-hepatic diseaseprogressions occurred with a median time of 10months (IQR 6-11months). Long-term (more than 1year) benzimidazole treatment stabilized the disease in 64% (9/14) of patients with R1 status. The overall survival rate was 97%. Conclusions: Liver AE can be safely and definitively treated with LR, provided that R0 resection is achieved. In cases of R1 resection, benzimidazole therapy seems to be effective in stabilizing the intra-hepatic disease and preventing extra-hepatic recurrence.