Abstract
The principal objectives to be achieved by surgical treatment are total removal of all parasitic elements, avoidance of spillage of contents of the cyst and management of the residual pericyst cavity. Thirty four patients with thirty five hepatic hydatid disease were included in the study. The data for this work were collected between 9-2015 till 9 -2016. The mean age were 38.6+13.2 years. There were twenty female and fourteen males. The main presentation was upper abdominal mass, 25 (73.5%) were in the right lobe, 8 (23.5%) were in the left lobe and only one (3%) was bilaterally presented. Conservative surgery in the form of cystotomy (with or without omental packing), and external drainage were applied to 32 cysts (91.4%) while radical surgery were applied to three cysts (8.6%) in the form of pericystectomy and partial hepatectomy. LOS in the conservative group was 6.3+2.5 day while in the radical group was 13.3+8.3 day (P<0.001 HS). There were two cases of post operative bile leak in the omental pack group (22.2%) and only one case (33.3%) among the three cases of external drainage group, so in the conservative surgery there were three cases (9.3%) and they resolved spontaneously. There were two redo one in the cystotomy patients, the other in the pericystectomy patients. Conclusion: Conservative surgery could be done with success in hepatic hydatid disease and resection procedures are too radical and extensive for benign lesions.
Highlights
Hydatid disease remains an important health problem in endemic areas and by the way of travel and immigration it can be encountered in non endemic areas as well
Hydatid disease can occur in any viscera but affects most commonly the liver, and rupture of the liver cysts into the bile ducts during the evaluation of the disease is the most frequent complication [1]
Included in the study there were thirty four patients with thirty five hepatic hydatid cyst, as there was only one patient presented with bilateral hepatic hydatid
Summary
Hydatid disease remains an important health problem in endemic areas and by the way of travel and immigration it can be encountered in non endemic areas as well. The surrounding skin becomes inflamed, and the patient is left with a draining wound that takes months to obliterate This procedure should be used only for infected cysts and in an occasional patient considered to be a poor risk [6]. After excising a reasonable portion of the redundant flaps of fused pericyst, the cavity may be left wide open (unroofing operation) This may result in intestinal obstruction, with a loop of intestine becoming stuck in the cavity. Introflexin is a simple and safe method This technique prevent dead space, and cover the inner surface of the cystic cavity by several layers of peritoneum, which has been demonstrated to have a high resorptive capacity [10]
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