title: Surgical management of hydatid liver disease.
abstract: BACKGROUND
  large retrospective clinical study describing the long-term experience of a single center in the surgical management of liver echinococcosis in an endemic area.
  
  
  METHODS
  232 patients were operated for liver hydatid disease between 1978 and 2012. Seventy-three patients (Group A) underwent a radical procedure (total pericystectomy or hepatectomy), while 145 (Group B) were treated with a more conservative method (partial cystectomy, with external drainage, omentoplasty or capitonnage) and 14 (Group C) received a combination of total and partial cystectomies. Morbidity, mortality, post-operative complications and recurrence rates in the long-term setting were retrospectively evaluated.
  
  
  RESULTS
  Group A patients were treated with zero mortality and a morbidity rate of 10.95%. No recurrence was documented. In Group B, mortality reached 2.76%, (p = 0.153 compared to Group A) morbidity 24.13% (p = 0.021) and there were 10 cases of relapse (6.9%) at three-year complete follow-up (p = 0.989). Extrahepatic sites of disease were not uncommon.
  
  
  CONCLUSIONS
  radical surgical procedures were better tolerated by patients and yielded better results in terms of recurrence rates.
authors.affiliation: Department of Surgery, University Hospital of Ioannina, Ioannina, Greece. Electronic address: georgmd7@gmail.com.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Georgiou
authors.affiliation: Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Lianos
authors.affiliation: Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Avrilios
authors.initials: A
authors.lastname: Lazaros
authors.affiliation: Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Haralampos V
authors.initials: HV
authors.lastname: Harissis
authors.affiliation: Department of Surgical Sciences and Human Morphology, 1st Division of General Surgery, Insubria University, Varese-Como, Varese, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mangano
authors.affiliation: Department of Surgical Sciences and Human Morphology, 1st Division of General Surgery, Insubria University, Varese-Como, Varese, Italy.
authors.forename: Gianlorenzo
authors.initials: G
authors.lastname: Dionigi
authors.affiliation: Department of Surgery, University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Katsios
mesh_terms: D000328:Adult; D015653:Cystectomy / Q000379:methods / Q000401:mortality*; D004322:Drainage; D004444:Echinococcosis, Hepatic / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies
keywords: Echinococcosis; Liver hydatid disease; Parasitic cyst; Pericystectomy; Radical surgical procedures