Surgical treatment of hydatid disease of the liver: 25 years of experience.
BACKGROUND
The aim of this study was to evaluate the results of conservative and radical treatment of liver hydatid disease.


METHODS
Records of patients who underwent surgery for liver hydatid disease between 1980 and 2005 were reviewed. Outcomes measured were operative morbidity and mortality, hospital stay, and recurrence.


RESULTS
Two hundred fourteen patients underwent conservative treatment (external drainage, marsupialization, omentoplasty), and 240 had radical surgery (hepatic resection, cystopericystectomy). Operative morbidity was 79.9% and 16.2% for conservative and radical procedures, respectively (P < .001). Operative mortality was 6.5% for conservative procedures and 9.2% for radical procedures (P = .3). The recurrence rate was 30.4% in patients having conservative surgery and 1.2% in patients undergoing radical surgery (P < .001). No recurrences occurred in patients with clear cysts after conservative surgery.


CONCLUSIONS
Cystopericystectomy was a safe and effective procedure that achieved excellent immediate and long-term results. Hepatic resection should be considered only in exceptional cases, because it involves the unnecessary sacrifice of healthy hepatic parenchyma. Conservative surgery and alternative procedures should be restricted to the treatment of clear cysts and to patients who cannot undergo radical surgery.
Tagliacozzo
Sandro
S
Division of Gastroenterologic and Hepato-Bilio Pancreatic Surgery, First Department of Surgery, Sapienza University Medical School, Rome, Italy.
Miccini
Michelangelo
M
Amore Bonapasta
Stefano
S
Gregori
Matteo
M
Tocchi
Adriano
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods* / Q000401:mortality; D004444:Echinococcosis, Hepatic / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult