Organ-sparing surgical treatment of giant hepatic hydatid cysts.
BACKGROUND
Excision of giant hepatic hydatid cysts may be associated with loss of hepatic tissue. We describe a method for obliterating spacious residual cavities that promotes salvage of healthy liver parenchyma.


METHODS
After simple cystectomy, the residual cavity is obliterated by manual compression of the healthy liver parenchyma from the left and right toward the midline of the cavity. While compression is maintained, the approximated edges of the cyst's fibrous capsule are closed with mattress sutures. Omentoplasty or gelatine sponges are used to fill the dead space prior to suturing of the fibrous capsule.


RESULTS
The method was used in 8 patients between 1993 and 2000. No sepsis, postoperative bile leak, or other complications occurred. No long-term adverse effects were found.


CONCLUSIONS
This method is simple and effective for obliteration of extremely large residual cavities after cystectomy for liver hydatidosis. It may be used safely in selected patients.
Losanoff
Julian E
JE
Department of Surgery, M580 Health Sciences Center, University of Missouri-Columbia School of Medicine, One Hospital Dr., Columbia, MO 65212, USA.
Richman
Bruce W
BW
Jones
James W
JW
D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome
D000871:Anthelmintics; D015766:Albendazole