[Diagnosis and treatment of hydatid cysts of the liver. Apropos of 87 cases operated on between 1980 and 1992].
Human echinococcosis is still endemic in some areas of the world, including Mediterranean countries and Lebanon. Because there is no effective medical therapy, surgery remains the principal mode of treatment. A consecutive series of 87 patients operated on for liver hydatid disease between January 1980 and March 1992 in the division of General Surgery at Saint George's Hospital, Beirut, were analyzed. Patients with hydatic cysts in other sites than liver were excluded from the study. There were 39 men (45%), and 48 women (55%) aged 12 to 75 years (mean 43). The right lobe of the liver was affected in 67 cases (77%), the left lobe in 18 cases (20.6%), and both lobes in 2 cases (2.4%). Clinical symptomatology consisted of abdominal pain, fever, jaundice, urticaria, and an abdominal mass. Preoperative diagnosis was established using imaging studies: plain abdominal films, ultrasonography, computed tomography, and serologic tests. Cases were classified into 3 groups: G1 (n = 44, 50.5%) had a partial resection of the cyst followed by an external drainage; G2 (n = 15, 17.2%) had a partial resection of the cyst with a filling of the residual cavity; G3 (n = 28, 32.2%) made benefit of complete resection of the cyst (pericystectomy) with or without partial hepatectomy. In this retrospective study we compared the results of these different surgical techniques: postoperative complications and mortality, hospital stay of patient. We noted the better postoperative course of the non-drained patient (G2 and G3). Three patients died during the postoperative period because of septic complications. Conclusions and general recommendations are proposed.
Daher
M
M
Service de chirurgie générale et digestive, Hôpital Saint Georges, Beyrouth, Liban.
Abi-Akl
A
A
Rassi
Z
Z
Souraty
P
P
el-Khazen
M
M
Khalife
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004322:Drainage; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography