[Diagnostic and therapeutic approach in hepatic echinococcosis complicated by mechanical jaundice]

The article presents the results of the treatment of 43 patients with echinococcosis of the liver the course of which was complicated by mechanical jaundice (MJ). In 11 patients MJ arose as a result of cystic content break into the bile ducts, in 32 patients, due to cystic compression of the lobular bile ducts. An effective scheme of the patients' examination is proposed which involved present-day ultrasound, X-ray and endoscopic methods. The system of objective evaluation of the patients' condition is outlined as designed for planning surgical policy. In non-severe disease the patients are operated after standard preparation within 24 hours after hospitalization. If the disease is more severe, the patients demand preparation including extracorporeal detoxication and cholangiostomy. In serious conditions the operations are made to remove the cyst content and cholestasis. This differentiated diagnostic and therapeutic policy diminished postoperative lethality from 15.2 to 6.9%.