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Un caso fatal de equinococosis hepática alveolar compleja

Li Xin¹, Li Mengmeng², Yu Huixia²

¹Department of Hepatobiliary Surgery, Chifeng Multiple Hospital, Chifeng, China.

Parasites, hosts and diseases

|February 11, 2026

Resumen

La resección radical para la equinococosis alveolar hepática avanzada (EAH) es compleja. Este caso destaca el equilibrio crítico entre la cirugía y la función hepática, enfatizando la necesidad de una robusta tromboprofilaxis postoperatoria para prevenir complicaciones fatales.

Área de la Ciencia:

Hepatología Hepatología.
Oncología Quirúrgica Oncología Quirúrgica.
Enfermedades infecciosas Enfermedades infecciosas.

Sus antecedentes:

La equinococosis alveolar hepática (EAH) presenta desafíos quirúrgicos significativos, especialmente con la participación vascular crítica.
La AEH avanzada puede invadir el hilo, el conducto biliar y los vasos hepáticos, lo que complica la resección radical.

Objetivo del estudio:

Informar sobre los dilemas de gestión peri-procedural en la resección radical para HAE avanzado.
Para resaltar la importancia de equilibrar la resección radical con la preservación de la función hepática residual.
Para subrayar la necesidad de una tromboprofilaxis postoperatoria integral.

Principales métodos:

Un informe de caso de una mujer de 58 años de edad con HAE avanzada que involucra estructuras hepáticas y suprarrenales extensas.
La intervención quirúrgica incluyó trisegmentectomía derecha, reconstrucción de la vena hepática izquierda, auto-trasplante y adrenalectomía.
El tratamiento incluyó la evaluación intraoperatoria Doppler, la trombectomía de emergencia y la trombólisis transcatéter para la trombosis postoperatoria de la vena portal.

Principales resultados:

El paciente desarrolló una trombosis abrupta de la vena portal 3 horas después de la cirugía, lo que requirió una intervención de emergencia.
A pesar de las intervenciones, el volumen hepático residual fue insuficiente (28% SLV), lo que condujo a una insuficiencia hepática progresiva.
El paciente finalmente falleció por insuficiencia multiorgánica 9 días después de la operación.

Conclusiones:

La resección radical para la AEH compleja requiere una cuidadosa consideración de la función hepática residual.
La trombosis postoperatoria de la vena portal es una complicación crítica que requiere un tratamiento rápido.
La tromboprofilaxis integral es imperativa después de cirugías complejas para HAE avanzado para mejorar los resultados.

Palabras clave:

La equinococcosis es una enfermedad de la equinococosis.Trasplante de hígado trasplante de hígado.La trombosis de la vena portal es una trombosis de la vena portal.

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