Abdominal echinococcosis: outcomes of conservative surgery.
BACKGROUND
Hydatid disease, infection with the larval stage of the cestode Echinococcus spp., represents a substantial disease burden worldwide. We report here the outcomes of conservative surgery in patients with abdominal echinococcosis.


METHODS
We carried out a retrospective review of patients who underwent conservative surgery for abdominal hydatid disease during the period January 2008 to December 2011. Perioperative outcomes were analysed after a mean follow-up of 24 months (range 6-36 months).


RESULTS
Thirty patients (mean age 40.4 years; male:female=7:3) underwent surgery. Most (29 patients) had a hepatic hydatid cyst and underwent partial cystectomy with omentoplasty; surgery was open in 22 cases (73%), laparoscopic in six cases (20%) and laparoscopic converted to open in one case (3%); one patient with a splenic cyst underwent open splenectomy. Cystobiliary communication was present in 10 cases (3%). Postoperative complications included transient biliary leak in two cases (7%), grade 1 surgical site infection in five cases (17%) and respiratory tract infection in three cases (10%), with no mortality. Mean hospital stay was 17 ± 9.2 days. None of the patients had recurrence of disease on follow-up imaging.


CONCLUSIONS
Conservative surgery offers an effective approach for abdominal echinococcosis, with minimal morbidity or recurrence, and is an alternative to radical procedures.
Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow 226010, India.
Anshuman
A
Pandey
Abhijit
A
Chandra
Shakeel
S
Masood
D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000969:Antinematodal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004443:Echinococcosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use; D008875:Middle Aged; D009852:Omentum / Q000469:parasitology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000969:Antinematodal Agents; D008463:Mebendazole; D015766:Albendazole
Abdominal echinococcosis; Conservative surgery; Hydatid disease; Morbidity; Outcomes; Recurrence