Results of 22 years of experience in radical surgical treatment of hepatic hydatid cysts.
OBJECTIVE
As there is still no effective parasiticide, treatment of hydatid cysts continues to be surgical. The possibility of treatment by PAIR. (puncture-aspiration-instillation-reaspiration) or laparoscopy has intensified the debate on the need for radical surgery. This study aims to show that radical surgical resection of the hepatic hydatid cyst is a safe and very effective technique, based on our results after 22 years of experience.


METHODS
Between 1974 and 1996 in 2 large Madrid hospitals we operated on 459 patients with 630 hydatid cysts. As technical advances and experience may vary results, patients were divided into 2 groups according to the period when they had undergone surgery: group A between 1974 and 1984; and group B between 1985 and 1996. Results of radical surgical resection and changes over the course of evolution of this technique were analyzed.


RESULTS
A progressive drop was observed in morbidity and mortality. There were no deaths related to technical complications amongst total cystopericystectomy cases. Between 1990 and 1996 mortality was 0%, 2% of patients presented biliary fistula and 4% infection of the residual cavity. Mean hospital stay was 15.2 days. Only 1 patient of the 459 presented recurrence.


CONCLUSIONS
As regards morbidity and mortality, technical advances and accumulated experience permit safe treatment of hepatic hydatid cysts by radical resection, with an almost nil recurrence rate. This makes it the technique of choice over others such as partial resection, PAIR or laparoscopy.
General and Digestive Surgery Department, and Abdominal Organ Transplant Unit, Hospital 12 de Octubre, Madrid, Spain.
O
O
Alonso Casado
E
E
Moreno González
C
C
Loinaz Segurola
A
A
Gimeno Calvo
I
I
González Pinto
B
B
Pérez Saborido
G
G
Paseiro Crespo
C
C
Ortiz Johansson
D000328:Adult; D001658:Biliary Fistula / Q000209:etiology; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000601:surgery; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies