title: Predisposing factors and surgical outcome of complicated liver hydatid cysts.
abstract: OBJECTIVE
  To evaluate the predisposing factors for peritoneal perforation and intrabiliary rupture and the effects of these complications on surgical outcome in liver hydatid disease.
  
  
  METHODS
  A total of 372 patients with liver hydatid cysts who had undergone surgical treatment were evaluated retrospectively. Twenty eight patients with peritoneal perforation, 93 patients with spontaneous intrabiliary perforation, and 251 patients with noncomplicated hydatid cysts were treated in our clinics.
  
  
  RESULTS
  When the predisposing factors for complications were evaluated, younger age, superficial position, and larger cyst dimensions (P < 0.05; range, 0.001-0.017) increased peritoneal perforation rates. It was shown that older age increased cyst dimensions, and presence of multiple and bilobar cysts increased intrabiliary rupture rates (P < 0.05; range, 0.001-0.028). Partial pericystectomy and drainage was the most frequent surgical procedure in all groups (71.6%). The incidence of post-operative complications in the peritoneal perforated group, in the intrabiliary ruptured group, and in the noncomplicated group was 25%, 16.1% and 5.5%, respectively. When compared, complication rates were significantly different (P = 0.002). When length of hospital stay was compared, there was no significant difference between the groups (P > 0.05). The overall recurrence rate was 3.8% (14 patients), but there was not any statistical difference among the patient groups (P = 0.13). The early postoperative mortality rate was 1.1%.
  
  
  CONCLUSIONS
  In peritoneally perforated and intrabiliary ruptured cases, the most important steps are irrigation of the peritoneal cavity and clearance of the cystic material from the biliary tree.
authors.affiliation: Department of General Surgery, Erciyes University School of Medicine, 38039, Kayseri, Turkey. acakcan2002@yahoo.com
authors.forename: Alper
authors.initials: A
authors.lastname: Akcan
authors.forename: Erdogan
authors.initials: E
authors.lastname: Sozuer
authors.forename: Hizir
authors.initials: H
authors.lastname: Akyildiz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozturk
authors.forename: Altay
authors.initials: A
authors.lastname: Atalay
authors.forename: Zeki
authors.initials: Z
authors.lastname: Yilmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000150:complications; D016896:Treatment Outcome; D055815:Young Adult