ТАКТИКО-ТЕХНИЧЕСКИЕ АСПЕКТЫ У БОЛЬНЫХ ЭХИНОКОККОЗОМ

Аннотация

На основании анализа историй болезни 327 пациентов с эхинококкозом печени (ЭП) разработана тактика хирургического лечения с учетом оптимального доступа в зависимости от локализации кисты; определены показания для декомпрессии желчных путей, в том числе и с применением эндоскопической техники. Ключевые слова: эхинококкоз, эхинококкэктомия, ЭРПХГ, папиллосфинктеротомия. Рахманов Косим Эрданович, 1-сон хирургик касалликлари кафедраси доценти Самарқанд Давлат тиббиёт институти Абдурахмонов Диёр Шукуруллаевич, 1-сон хирургик касалликлари кафедраси ассистенти Самарқанд Давлат тиббиёт институти Анарбоев Санжар Алишерович, 1- сон хирургик касалликлари кафедраси ассистенти Самарқанд давлат тиббиёт институти ЖИГАР ЭХИНОКОККОЗИ БИЛАН КАСАЛЛАНГАН БЕМОРЛАРДА ЖАРРОХЛИК ТАКТИКАСИ АННОТАЦИЯ Жигар эхинококкози (ЖЭ) билан касалланган 327 беморда касаллик анамнезини таҳлил қилиш асосида кистанинг локализациясига боғлиқликка оптимал кириш имкониятини ҳисобга олган ҳолда жарроҳлик даволаш тактикаси ишлаб чиқилди; эндоскопик усуллардан фойдаланган ҳолда, ўт йўлларини декомпрессиялаш кўрсаткичлари аниқланди. Калит сўзлар: эхинококкоз, эхинококектомия, ЭРПХГ, папиллосфинктеротомия. Rakhmanov Kosim Erdanovich, Associate Professor of the Department of Surgical Diseases No. 1 Samarkand State Medical Institute Abdurakhmanov Diyor Shukurullaevich, Assistant of the Department of Surgical Diseases No. 1 Samarkand State Medical Institute Anarboev Sanjar Alisherovich, Assistant of the Department of Surgical Diseases No. 1 Samarkand State Medical Institute 106 JOURNAL OF HEPATO-GASTROENTEROLOGY RESEARCH | ЖУРНАЛ ГЕПАТО-ГАСТРОЭНТЕРОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ №3,1 (том II) 2021 TACTICAL AND TECHNICAL ASPECTS IN PATIENTS WITH LIVER ECHINOCOCCOSIS ANOTATION Based on the analysis of the case histories of 327 patients with liver echinococcosis (LE), surgical treatment tactics were developed considering optimal access depending on the location of the cyst; indications for biliary tract decompression, including using endoscopic techniques, were determined. Key words: echinococcosis, echinococcectomy, ERPH, papillosphincterotomy. Echinococcosis is a dangerous natural focal the location of the cyst and the nature of complications. parasitic disease of domestic animals and humans, The choice of access depended on the topical location of occurring sporadically and endemically. Areas that are the cyst. When cysts were localized in the second and endemic for echinococcosis include Mountainous areas, third segments, echinococcectomy was performed from echinococcosis is included in the who list of diseases the upper end of the spine. – median access [28], if the requiring radical eradication. The problem of first, fourth, fifth, and sixth segments were affected – echinococcosis remains relevant, since the disease is from the subcostal segment [24], if they were located in quite common, and treatment issues are becoming the seventh and eighth segments, thoracotomy with debatable. Among the lesions of various organs and diaphragmotomy was performed [23]. one patient had a tissues with echinococcosis, the frequency of liver combined access (thoracotomy, laparotomy), considering damage is 44-84 % [1,2,3,4,5]. Prevalence of echinococcal lesion of the left lung and right lobe of the echinococcosis inabout all of them the incidence of liver. Giant cysts, multiple cysts of both lobes of the liver echinococcosis in the region is 1 per 10,000 inhabitants, in 9 cases required transverse laparotomy or total median in the Republic of Uzbekistan 0.39 per 1000 inhabitants laparotomy. laparoscopic surgery was performed in five (2017). the Incidence of echinococcosis in the region is 4 patients. One patient underwent videothoracoscopic times higher than the incidence in the Republic of surgery. operation for echinococcosis of the right lung Uzbekistan [7,8,9,10]. The problem of surgical treatment and right lobe of the liver the diagnostic Algorithm of liver echinococcosis still remains relevant in many included clinical laboratory examinations, ultrasound regions of Uzbekistan [8,9,10,11,12,13,14]. 483 patients examination of the liver, computed tomography, chest x- with echinococcosis were operated on in the 1st clinic of ray, ERPHG. Several patients (10) underwent liver MRI. Samgmi from 2005 to 2018, 327 of them were diagnosed This complex of examinations allowed us to obtain an with LE. the difficulties of effective surgical treatment accurate segmental localization of cysts, their size, are due to the lack of a generally recognized optimal number, and signs of a complicated course of the disease, treatment option, depending on the location of the cyst, such as mechanical jaundice, suppuration of the cyst, the condition of the cyst. fibrotic capsule and the lack of a connection of the cyst with the bile ducts, and cyst single view on the methods of treatment of the fibrotic breakthrough into the biliary system. In complex bed after removal of the cyst [16,17,18,19,20,21,22