title: Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis.
abstract: BACKGROUND
  Hydatidosis is the result of infection with the larval stages of some species of the genus Echinococcus. Treatment approaches for hydatid cysts include the use of albendazole, surgery, and/or medico-surgical procedures. The choice of the therapeutic surgical approach depends on the cyst number and localization, surgeon expertise, and presence of complications. The present study aimed to compare the outcomes of the following therapeutic approaches for the treatment of hepatic hydatid cysts: pericystectomy; the puncture, aspiration, injection, and reaspiration (PAIR) technique; and the PAIR technique followed by deroofing, evacuation of cysts, and omentoplasty.
  
  
  METHODS
  The 54 patients were divided into 3 groups: Group I (14 patients) who underwent pericystectomy, Group II (23 patients) who underwent the PAIR technique, and Group III (17 patients) who underwent the PAIR technique followed by deroofing and omentoplasty. The diagnosis of hydatid cysts was based on serological testing using enzyme-linked immunosorbent assay, abdominal ultrasound, and parasitological examination of the cyst contents. Morbidity, mortality, length of hospital stay, recurrence, and postoperative complications were evaluated.
  
  
  RESULTS
  Postoperative bleeding, infection, and recurrence were reported in Groups I and II; Group III did not experience postoperative infection and had shorter hospital stays. Recurrence and postoperative complications did not occur in Group III.
  
  
  CONCLUSIONS
  The partial surgical procedure with deroofing, evacuation of the cysts, and omentoplasty, as performed in the present study, is recommended as a safe and effective method for elimination of the entire parasite with minimal possibility for intra-peritoneal spillage.
authors.affiliation: Department of Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Abdelraouf
authors.affiliation: Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Amany Ahmed Abd
authors.initials: AA
authors.lastname: El-Aal
authors.affiliation: Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Eman Yassin
authors.initials: EY
authors.lastname: Shoeib
authors.affiliation: Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Samar Sayed
authors.initials: SS
authors.lastname: Attia
authors.affiliation: Department of Medical Parasitology, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Nihal Ahmed
authors.initials: NA
authors.lastname: Hanafy
authors.affiliation: Department of Tropical Medicine, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassani
authors.affiliation: Department of Tropical Medicine, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt.
authors.forename: Soheir
authors.initials: S
authors.lastname: Shoman
mesh_terms: D000328:Adult; D000818:Animals; D015331:Cohort Studies; D004444:Echinococcosis, Hepatic / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome