title: Surgical management of liver hydatidosis: a multicentre series of 1412 patients.
abstract: BACKGROUND
  The management of hydatid liver disease (HLD) includes various nonsurgical and surgical treatment options.
  
  
  METHODS
  The purpose of the present longitudinal study was to report the changes in surgical management and the consequent outcome of HLD patients in 10 referral surgical centres in Argentina from 1975 to 2007. The study result analysis was divided into two study periods (1975-1990 and 1991-2007).
  
  
  RESULTS
  A total of 1412 patients underwent radical (Group 1: 396 patients), conservative (Group 2: 748 patients) or combined (Group 3: 536 interventions in 268 patients) surgical procedures. The overall mortality and complication rate (Clavien I-IV) was 1.8 and 39% respectively. The complication rate was significantly lower in Group 1 (26%) compared with Group 2 (45%) and Group 3 (42%) There was a significant decrease in mortality (2.3 vs. 1%), complication (42 vs. 34%) and early reoperation (12 vs. 6%) rates between the first study part (918 patients) and the second study part (494 patients). During a median follow-up of 7 years, there was a significant decrease in the first part of this study in the late reoperation rate (8.4-3%) and in disease recurrence (9-1.6%).
  
  
  CONCLUSIONS
  This large national observational multicentre series shows a significant improvement in surgical management of HLD in Argentina, with a decrease in mortality, morbidity, early and late reoperation and recurrence rates. A recent trend was observed in favour of an earlier diagnosis, less complicated clinical presentation and recent use of minimally invasive approaches.
authors.affiliation: Department of Surgery, Hospital Italiano Garibaldi and Medical School IUNIR, Rosario, Argentina. secchimario@hotmail.com
authors.forename: Mario A
authors.initials: MA
authors.lastname: Secchi
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pettinari
authors.forename: Carlos
authors.initials: C
authors.lastname: Mercapide
authors.forename: Ricardo
authors.initials: R
authors.lastname: Bracco
authors.forename: Carlos
authors.initials: C
authors.lastname: Castilla
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cassone
authors.forename: Pablo
authors.initials: P
authors.lastname: Sisco
authors.forename: Oscar
authors.initials: O
authors.lastname: Andriani
authors.forename: Leonardo
authors.initials: L
authors.lastname: Rossi
authors.forename: Jorge
authors.initials: J
authors.lastname: Grondona
authors.forename: Lisandro
authors.initials: L
authors.lastname: Quadrelli
authors.forename: Raúl
authors.initials: R
authors.lastname: Cabral
authors.forename: Nicolás
authors.initials: N
authors.lastname: Rodríguez León
authors.forename: Carlos
authors.initials: C
authors.lastname: Ledesma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D002648:Child; D004444:Echinococcosis, Hepatic / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult