A retrospective study comparing the different surgical procedures for the treatment of hydatid disease of the liver.
OBJECTIVE
The purpose of this study was to compare the security and effectiveness of the different surgical procedures used for treatment of the liver infestations with larvae of the dog tapeworm (Echinoocccus granulosus).


METHODS
55 patients with echinococcal cysts in the liver were treated surgically at our department between 1987 and 1999. The patients were grouped according to the mode of surgical technique and comprised 16 anatomical liver resections, 26 pericystectomies and 13 endocystectomies. The results of the different procedures have been analyzed statistically.


RESULTS
The decision which procedure was to be performed was based on the severity of the disease. Complications requiring relaparotomy occurred in 5% of all cases, not showing any predisposition to a certain technique. Blood loss and duration of hospitalization was lowest in the endocystectomy group; however, the differences were not statistically significant. At a median follow-up period of 84 months, recurrences were noted in 2 cases (4%), 1 after pericystectomy and 1 after resection.


CONCLUSIONS
There was no substantial evidence that the more radical procedure carries a lower risk of recurrence, and there was convincing evidence that endocystectomy is the most careful procedure in regard to blood loss and duration of hospitalization.
Department of Hepatobiliary Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. l.mueller@uke.uni-hamburg.de
Lars
L
Mueller
Dieter C
DC
Broering
Yogesh
Y
Vashist
Lutz
L
Fischer
Christian
C
Hillert
Xavier
X
Rogiers
D000293:Adolescent; D000328:Adult; D000368:Aged; D000871:Anthelmintics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome
D000871:Anthelmintics