title: Liver hydatidosis: reasoned indications of surgical treatment. Comparison between conservative and radical techniques Retrospective study.
abstract: Liver hydatidosis is a focal benign parasitic disease that still cause high rate of morbidity particularly in the Mediterranean area. A retrospective study comparing conservative and radical techniques in a General and Urgent Surgery operative unit was carried out in order to find signs of its surgical treatment. A total of 50 patients, 24 men and 26 women, who experienced a surgical treatment from 2000 to 2011, participated, and through the Fisher's Exact Test characteristics of the cysts, post-operative complications and relapse were compared. As a result, 29 patients undertook conservative surgery, while 21 radical surgery. There was a relationship between characteristics of the cysts and the technique chosen, (p<0.001). Likewise, whenever the diameter was smaller than 10cm or localized in the left lobe a radical technique was used. Conversely, a conservative technique was used when the diameter was bigger than 10 cm or they were localized in the right lobe or complicated by intra-biliary or intra-peritoneal rupture as well as in contiguity with major vascular and biliary structures. In this regard, while the post-operative morbidity was related to the conservative techniques (p<0.004), the relapses tended to not be related to any techniques in our case (p<0.14). In conclusion, in a non hepato-bilio-pancreatic center a radical surgery including liver resection is suggested for left lobe's cysts, while a conservative technique tends to be more effective for right lobe's cysts mainly if complex. Consequently, patients with complicated presentation could explain why conservative treatment causes higher rate of morbidity.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Salamone
authors.forename: Roberta
authors.initials: R
authors.lastname: Tutino
authors.forename: Jenny
authors.initials: J
authors.lastname: Atzeni
authors.forename: Leo
authors.initials: L
authors.lastname: Licari
authors.forename: Nicola
authors.initials: N
authors.lastname: Falco
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Orlando
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004444:Echinococcosis, Hepatic / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012802:Sicily / Q000453:epidemiology; D016896:Treatment Outcome