Surgical techniques and treatment for hepatic hydatid cysts.
OBJECTIVE
Hepatic hydatid cysts (HHCs) are a parasitic infestation caused by several species of Echinococcus. We examined the clinical features of HHCs and evaluated the results of various surgical procedures.


METHODS
One hundred and sixty-nine patients aged between 17 and 84 years underwent surgery for HHCs within a 12-year period. We recorded the demographic data, location of the cysts, surgical procedures used, morbidity, recurrences, and hospital stay.


RESULTS
Most (90.5%) of the patients presented with symptoms, but 16 (9.5%) patients reported no symptoms. The most common symptom was abdominal pain. The overall number of cysts was 216 HHCs and 9 concomitant hydatid cysts in other abdominal organs. The surgical treatments consisted of hepatic resection in 8 (4.7%) patients, cystostomy with drainage in 43 (25.5%), cystostomy with capitonnage in 22 (13%), cystostomy with omentoplasty in 72 (42.6%), and cystectomy in 24 (14.2%). Splenectomy or nephrectomy was also performed in nine patients. Postoperative complications developed in 36 (21.3%) patients, and three suffered recurrences. The postoperative mortality rate was 1.2%. Postoperative complications were more frequent after cystostomy with capitonnage than after cystostomy with omentoplasty (P < 0.001) or cystectomy (P = 0.0037). The additional procedures prolonged the hospital stay.


CONCLUSIONS
Current surgical techniques combined with antiscolicidal therapy using albendazole are effective and safe treatments for HHCs, associated with low morbidity, mortality, and recurrence rates.
Gourgiotis
Stavros
S
Hepatobiliary and Pancreatic Surgery Department, Royal London Hospital, Whitechapel, London, E1 1BB, UK.
Stratopoulos
Charalabos
C
Moustafellos
Panagiotis
P
Dimopoulos
Nikitas
N
Papaxoinis
George
G
Vougas
Vasilis
V
Hadjiyannakis
Evangelos
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015766:Albendazole / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D002763:Cholecystectomy; D002768:Choledochostomy; D003131:Combined Modality Therapy; D003559:Cystostomy; D004322:Drainage; D004444:Echinococcosis, Hepatic / Q000188:drug therapy* / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D013156:Splenectomy
D000981:Antiprotozoal Agents; D015766:Albendazole