Surgical management of hydatid liver disease

Int J Surg. 2015 Aug:20:118-22. doi: 10.1016/j.ijsu.2015.06.058. Epub 2015 Jun 26.

Abstract

Background: large retrospective clinical study describing the long-term experience of a single center in the surgical management of liver echinococcosis in an endemic area.

Methods: 232 patients were operated for liver hydatid disease between 1978 and 2012. Seventy-three patients (Group A) underwent a radical procedure (total pericystectomy or hepatectomy), while 145 (Group B) were treated with a more conservative method (partial cystectomy, with external drainage, omentoplasty or capitonnage) and 14 (Group C) received a combination of total and partial cystectomies. Morbidity, mortality, post-operative complications and recurrence rates in the long-term setting were retrospectively evaluated.

Results: Group A patients were treated with zero mortality and a morbidity rate of 10.95%. No recurrence was documented. In Group B, mortality reached 2.76%, (p = 0.153 compared to Group A) morbidity 24.13% (p = 0.021) and there were 10 cases of relapse (6.9%) at three-year complete follow-up (p = 0.989). Extrahepatic sites of disease were not uncommon.

Discussion: radical surgical procedures were better tolerated by patients and yielded better results in terms of recurrence rates.

Keywords: Echinococcosis; Liver hydatid disease; Parasitic cyst; Pericystectomy; Radical surgical procedures.

MeSH terms

  • Adult
  • Cystectomy / methods
  • Cystectomy / mortality*
  • Drainage
  • Echinococcosis, Hepatic / mortality
  • Echinococcosis, Hepatic / surgery*
  • Female
  • Hepatectomy / methods
  • Hepatectomy / mortality*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Recurrence
  • Retrospective Studies