Hydatid disease of the liver: long term results of surgical treatment.
Many surgical techniques have been used in the management of the hydatid disease of the liver. The aim of the treatment should be to minimize the high risks of complication and recurrence. The Authors reviewed the records of 33 consecutive cases of hydatid disease of the liver surgically treated during a 6 year period (1974-1979) to determine complications and long term results (10 years) of the different surgical procedures applied. Partial pericystectomy with tube drainage was the most common treatment (30/49 cysts) followed by total pericystectomy (15/49) and partial liver resection (4 cases). Complication rates were 13.3%, 6.6% and 0% respectively. There was no perioperative mortality. In 1989 all patients were investigated for cystic recurrence: it was possible to study by CT scan or abdominal US 23 patients. Only three of them showed an asymptomatic recurrent disease. They had undergone partial pericystectomy in 1974 (2 cases) and 1977 (1 case) for recurrent hydatid disease of the right hepatic lobe and, in one case, even of the rectus muscle. Complication and recurrence rates seem to be higher with conservative surgical procedures compared to more radical treatment, but indiscriminate application of total pericystectomy or major liver resection may be followed by a higher incidence of major postoperative complications and mortality. Therefore, total pericystectomy or wedge resection were performed only for peripheral cysts since we believe liver resection for hydatid cyst is a very radical approach taking into account the type of disease.
Cangiotti
L
L
Clinica Chirurgica, Università degli Studi di Brescia.
Giulini
S M
SM
Muiesan
P
P
Nodari
F
F
Begni
A
A
Tiberio
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed