title: Hydatid disease of the liver: thirty years of surgical experience.
abstract: Hydatid disease of the liver is a relatively frequent disease. Although the natural history is almost completely known, several complications may occur. The aim of this study was to show that radical surgical resection of the hepatic hydatid cyst is a safe and very effective technique, based on our results after 30-year experience. A review of most significant studies was carried out. We retrospectively evaluated our surgical cases. From January 1973 to December 2003 we treated 216 patients, 98 males and 118 females. Survival was compared with the Kaplan-Meier test, using log-rank analysis to compare data. Differences with a p value less than 0.05 were considered significant. A total of 279 cysts were excised. We performed pericystectomy in 122 cases, 73 of which closed. We also performed 19 atypical resections, 10 segmentectomies, 20 lobectomies and 2 percutaneous treatments. In more than 90% of cases, preoperative data collection was completed by preoperative ultrasound. The cumulative morbidity was 13%. The recurrence rate amounted to 4.3% at 5 years and 7% at 10 years: of these, 6 occurred after non-radical surgery and 2 after total pericystectomy or liver resection (p < 0.001). Technical advances and accumulated experience permit safe treatment of hepatic hydatid cysts by radical resection, with an almost zero recurrence rate, making it the treatment of choice over partial resection. The utility of percutaneous treatment remains confined to limited indications, such as laparoscopy.
authors.affiliation: Department of General, Geriatric and Oncological Surgery and Advanced, Technology University "Federico II", Naples.
authors.forename: Carlo
authors.initials: C
authors.lastname: De Werra
authors.forename: Salvatore
authors.initials: S
authors.lastname: Condurro
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tramontano
authors.forename: Mario
authors.initials: M
authors.lastname: Perone
authors.forename: Ivana
authors.initials: I
authors.lastname: Donzelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Lauro
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giuseppe
authors.forename: Rosa
authors.initials: R
authors.lastname: Di Micco
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pascariello
authors.forename: Antonio
authors.initials: A
authors.lastname: Pastore
authors.forename: Giorgio
authors.initials: G
authors.lastname: Diamantis
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Galloro
mesh_terms: D000328:Adult; D000368:Aged; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000276:immunology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007159:Immunologic Tests; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome