Surgical management of liver hydatidosis: a multicentre series of 1412 patients.
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.
Secchi
Mario A
MA
Department of Surgery, Hospital Italiano Garibaldi and Medical School IUNIR, Rosario, Argentina. secchimario@hotmail.com
Pettinari
Ricardo
R
Mercapide
Carlos
C
Bracco
Ricardo
R
Castilla
Carlos
C
Cassone
Eduardo
E
Sisco
Pablo
P
Andriani
Oscar
O
Rossi
Leonardo
L
Grondona
Jorge
J
Quadrelli
Lisandro
L
Cabral
Raúl
R
Rodríguez León
Nicolás
N
Ledesma
Carlos
C
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