Abdominal echinococcosis: outcomes of conservative surgery

Trans R Soc Trop Med Hyg. 2014 May;108(5):264-8. doi: 10.1093/trstmh/tru003. Epub 2014 Jan 30.

Abstract

Background: Hydatid disease, infection with the larval stage of the cestode Echinococcus spp., represents a substantial disease burden worldwide. We report here the outcomes of conservative surgery in patients with abdominal echinococcosis.

Methods: We carried out a retrospective review of patients who underwent conservative surgery for abdominal hydatid disease during the period January 2008 to December 2011. Perioperative outcomes were analysed after a mean follow-up of 24 months (range 6-36 months).

Results: Thirty patients (mean age 40.4 years; male:female=7:3) underwent surgery. Most (29 patients) had a hepatic hydatid cyst and underwent partial cystectomy with omentoplasty; surgery was open in 22 cases (73%), laparoscopic in six cases (20%) and laparoscopic converted to open in one case (3%); one patient with a splenic cyst underwent open splenectomy. Cystobiliary communication was present in 10 cases (3%). Postoperative complications included transient biliary leak in two cases (7%), grade 1 surgical site infection in five cases (17%) and respiratory tract infection in three cases (10%), with no mortality. Mean hospital stay was 17 ± 9.2 days. None of the patients had recurrence of disease on follow-up imaging.

Conclusion: Conservative surgery offers an effective approach for abdominal echinococcosis, with minimal morbidity or recurrence, and is an alternative to radical procedures.

Keywords: Abdominal echinococcosis; Conservative surgery; Hydatid disease; Morbidity; Outcomes; Recurrence.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Albendazole / therapeutic use
  • Animals
  • Antinematodal Agents / therapeutic use
  • Child
  • Child, Preschool
  • Echinococcosis / drug therapy
  • Echinococcosis / epidemiology
  • Echinococcosis / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • India / epidemiology
  • Male
  • Mebendazole / therapeutic use
  • Middle Aged
  • Omentum / parasitology
  • Omentum / surgery*
  • Recurrence
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Antinematodal Agents
  • Mebendazole
  • Albendazole