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KARACİĞER KİST HİDATİĞİNDE LAPAROSKOPİK PERİKİSTEKTOMİ DENEYİMİMİZ

Amaç Çalışmanın amacı laparoskopik cerrahi tedavi uyguladığımız kist hidatik olgularını yaş, cinsiyet, kist yerleşimi, kist boyutu ve tipi, uygulanan tedavi, operasyon süresi, erken ve geç dönem komplikasyonları ve nüks açısından retrospektif olarak değerlendirmek ve bu bulguları literatürle karşılaştırmaktır. Gereç ve Yöntem Hastaların yaş, cinsiyet gibi demografik bilgileri, serolojik ve radyolojik tetkik sonuçları, kistlerin sayısı, Gharbi sınıflamasına göre tipi, boyutu, lokalizasyonu, operasyon şekli ve süresi, erken ve geç dönem komplikasyonları, hastanede kalış süreleri, mortalite ve morbidite verileri hastane kayıt sisteminden geriye dönük tarandı ve veri tabanı oluşturularak analiz edildi. Bulgular Hastaların yaş ortalaması 35.28 ±16.12 olup, %42.9’u kadın (6/14) ve %57.1’i erkek (8/14) hastalardan oluşmaktaydı. Hastaların en sık başvuru nedeni sırasıyla ağrı (%57.1) ve sarılık (%21.4) şikayetleriydi. Hastaların tamamına tanı aşamasında (Bilgisayarlı Tomografi) BT ve (Ultrasonografi) USG istendi. Medikal tedavi tüm hastalara uygulanmıştı. Tüm hastalara laparoskopik perikistektomi operasyonu yapıldı. Oral tedavi birinci gün başlandı. Hastaların üçünde (% 21.4) operasyon esnasında safra sızıntısı gelişti ve primer onarıldı. Postoperatif yedi hastada (%50.0, 7/14) safra sızıntısı gelişirken, bu hastalardan ikisinde (%14.3) ise Endoskopik Retrograd Kolanjiyo Pankreatografi (ERCP) gereksinimi oldu. Hastalar bir yıl süreyle takip edildi, bu sürede mortalite ve nüks gelişmedi. Sonuç Deneyimli merkezlerde ve tecrübeli cerrahlarca yapılan laparoskopik cerrahinin kist hidatik tedavisinde daha sık tercih edileceği düşünülmektedir.

Anahtar Kelimeler:

Kist Hidatik, ERCP, Laparoskopi.

OUR EXPERIENCE WITH LAPAROSCOPIC PERICYSTECTOMY IN LIVER HYDATID DISEASE

Objective The aim of the study is to retrospectively evaluate hydatid cyst cases in which we underwent laparoscopic surgical treatment in terms of age, gender, cyst location, cyst size and type, treatment applied, duration of operation, early and late complications, and recurrence, and compare these findings with the literature. Materials and Methods Demographic information of patients such as age, gender, serological and radiological examination results, number of cysts, type, size, localization, type and duration of operation, early and late complications, duration of hospital stay, mortality and morbidity data according to Gharbi classification. It was scanned retrospectively from the registry system and analyzed by creating a database. Results The mean age of the patients was 35.28 ±16.12 years, and 42.9% were female (6/14) and 57.1% were male (8/14).The most common complaints of patients were pain (57.1%) and jaundice (21.4%), respectively. CT (Computed Tomography) and USG (Ultrasound) were requested for all patients at the stage of diagnosis. Medical treatment was applied to all patients. All patients underwent laparoscopic pericystectomy operation. Oral treatment was started on the first day. Bile leakage developed during the operation in three (21.4%) patients and the primary was repaired. Bile leakage developed in seven patients (50.0%, 7/14) postoperatively, while two (14.3%) of these patients required Endoscopic Retrograde Cholangio-Pancreatography (ERCP). The patients were followed up for one year, during which time mortality and recurrence did not occur. Conclusion It is thought that laparoscopic surgery performed in experienced centers and by experienced surgeons will be preferred more frequently in the treatment of hydatid cyst.

Keywords:

Hydatid Cyst, ERCP, Laparoscopy,

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