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Volume 53, Issue 4, 2025

Online ISSN: 2560-3310

ISSN: 0350-8773

Volume 53 , Issue 4, (2025)

Published: 30.06.2025.

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Contents

01.01.2008.

Case Reports

LIVER RESECTION AT ECHINOCOCCUS CYST

Echinococcus is a zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. Vogeli and E. oligarthus. The most frequent at humans is a cystic form of the disease caused by E. granulosus, and rarely the alveolar one caused by E. multilocolaris seu alveolaris. It can affect all the organs and tissues. The most affected ones are: liver (70- 80%) and lungs (10-25%), while rarely, at 5% it can be found in spleen, kidneys, brain, heart, pancreas, mussels and skeleton. The only secure treatment of the primary echinococcosis is the surgical one. It should start immediately after the diagnosis is set in order to avoid complications which follow echinococcosis. Several surgical methods are used in practice for live echinococcus treatment: partial pericystectomia, total cystopericystectomia and liver resection. Aim of the work is to show the importance of the echinococcus cyst of liver and treatment methods. The patient presented in the work is Dj.G., female, register number of the disease history 355/14.05.2007., 61 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. During the surgery, we found a big echinococcus cyst localized in the second and third segment of liver, so we did a liver resection as a bisegmetectomia with total ekstirpacija of the cyst. Postoperative flow passed normally and the patient
was on the eight postoperative day sent to further home care in a generally and locally good state.

J. Mladenović, N. Videnović, S. Sekulić, S. Mladenović, R. Mladenović, P. Lukić, S. Aranđelović

01.12.2008.

Case Reports

OBSTRUCTIVE JAUNDICE AS THE CONSEQUENCE OF ECHINOCOCCUS CYST OF LIVER

Obstructive jaundice presents partial or complete blockade in the gall way towards intestinal tract. This blockade is caused by mechanical obstruction in the extrahepatitic bilioductule system. Etiologic factors which cause obstruction of the extrahepatitic gall ways are numerous. One of the reasons of appearing obstructive jaundice is penetration of the cyst parts or cyst sprout into the gall ways. Echinococcus is zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. vogeli i E. oligarthus. At humans, cystic form of disease caused by E. granulosus appears most frequently, while the alveolar one caused by E. multilocolaris seu alveolaris appears rarely. Aim of the work is to show the importance of the echinococcus cyst of the liver at the appearing of the obstructive jaundice , penetrating the cyst parts or cyst sprout in the gall ways. The patient presented in the work is E.C., male, register number of the disease history 404/05.06.2007, 20 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. Echinococcus cyst got complicated by its penetration into the gall ways, and manifested by jaundice, the signs of purulent cholangiitis, and bad general state of the patient, so the surgical treatment is absolutely indicated. During the surgery, after the done pericystectomia, cholendochotomia is done because of the enlarged cholangiitis, where the signs of purulent cholangiitis and 5 cyst sprouts are found and removed. Postoperative flow passed normally. Findings of done secondary cholangiography showed normal structure and transience of gall ways, so the T-drain was removed and the patient sent to further home care in a generally and locally good state.

J. Mladenović, N. Videnović, S. Mladenović, R. Mladenović, P. Lukić, S. Aranđelović

01.01.2005.

Professional paper

SURGICAL TREATMENT OF THE GALL BLADDER DISEASE AND THE BILIARY WAYS

Biliary calculosis is the most frequent disease of the hepathrombial system. Inflammation of the gall bladder appears in the acute and chronicle form. Acute inflammation presents one of the frequent complications of the gall bladder
calculosis. Acute inflammation of the gall bladder can appear in catarrhal, phlegmonous, gangrenous perforative form. Perforation of the inflamed changed gall bladder can lead to the diffuse biliary peritonitis, pericholecystitis and formation of
pericholecystitis infiltrate or abcess. Very often the acute inflammation of the gall bladder appears in combination with Acute inflammation of the pancreas. For the production of the work the biyearly material of the Emergency Surgical Centre
“Simonida” in Gračanica is used. In the ESC Simonida, in the period from January to December of 2004, 375 patients were operated. In the same period of time we operated 52 (13.86%) patients because of the gall bladder disease and biliary ways.
There were 45 female patients and 7 male ones. Gall bladder disease is 6.5 times more frequent at females in our material. Hard security situation and limited freedom of movement are one of the most important reasons of patients' late report to the
doctor, and appearance of the heavy forms of the inflammation of the gall bladder and biliary ways. The acute form of the inflammation of the gall bladder was noticed at 25 patients. The complications of the disease in the sense of cholecystopancreatitis, choledolithiasis, suppurating cholangiitis, choledolithiasis i cholecystoduodenal fistule were found at 27 patients. Postoperative complications were verified at 3 patients, wound infection at 2 patients and peritonitis at one
patient after drawing ouf the T-drain.

J. Mladenović, N. Videnović, D. Perić, P. Lukić

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