title: Surgical management of liver hydatid disease: subadventitial cystectomy versus resection of the protruding dome.
abstract: BACKGROUND
  The aim of this study was to compare postoperative outcome and long-term results after management of liver hydatid cysts (LHC) by subadventitial cystectomy (SC) and resection of the protruding dome (RPD) in two tertiary liver surgery centers.
  
  
  METHODS
  Medical records of 52 patients who underwent SC in one center, and 27 patients who underwent RPD in another center between 1991 and 2011 were reviewed. Patients underwent long-term follow-up, including serology tests and morphological examinations.
  
  
  RESULTS
  Postoperative mortality was nil. The rate of severe morbidity was 7.7 and 22% (p = 0.082), while the rate of serological clearing-up was 20 and 13.3% after SC and RPD, respectively (p = 1.000). After a mean follow-up of 41 months (1-197), four patients developed a long-term cavity-related complication (LTCRC) after RPD (including one recurrence) and none after SC (p = 0.012). All LTCRCs occurred in patients with hydatid cysts located at the liver dome; three required an invasive procedure by either puncture aspiration injection re-aspiration (N = 1) or repeat surgery (N = 2).
  
  
  CONCLUSIONS
  RPD exposes to specific LTCRC, especially when hydatid cysts are located at the liver dome, while SC allows ad integrum restoration of the operated liver. Therefore, SC should be considered as the standard surgical treatment for LHC in experienced hepato-pancreato-biliary centers.
authors: Department of General and Digestive Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Université Lyon 1, EMR 3738, 103 Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France, kayvan.mohkam@chu-lyon.fr.
authors: Kayvan
authors: K
authors: Mohkam
authors: Leila
authors: L
authors: Belkhir
authors: Martine
authors: M
authors: Wallon
authors: Benjamin
authors: B
authors: Darnis
authors: François
authors: F
authors: Peyron
authors: Christian
authors: C
authors: Ducerf
authors: Jean-François
authors: JF
authors: Gigot
authors: Jean-Yves
authors: JY
authors: Mabrut
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D004444:Echinococcosis, Hepatic / Q000097:blood / Q000473:pathology / Q000601:surgery*; D004446:Echinococcus / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008099:Liver / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth