Surgical treatment of hydatid cysts of the liver.

Abstract

Echinococcosis is a zoonotic disease that occurs throughout the world. The purpose of this study was to assess the clinical features and results of surgical treatment of hepatic hydatid cysts. One hundred and two patients operated on between 1991 and 2002 were reviewed retrospectively. The patients' demographic data, location, number and size of cysts, type of surgical procedure performed, morbidity, recurrences and duration of hospital stay were recorded. There were 74 male and 28 female patients with ages ranging from 15 to over 60 years. The most frequent symptom was abdominal pain. From the total of 136 hepatic cysts, 54 (39.7 per cent) were managed by cystostomy and drainage, 40 (29.4 per cent) by cystostomy and capitonnage, 16 (11.8 per cent) by cystostomy and omentoplasty, 24 (17.6 per cent) by cystectomy and two (1.5 per cent) by left lateral hepatic resection. Postoperative complications were more frequent following cystostomy with omentoplasty (six of 16 patients) compared with cystectomy (none of 18) (P = 0.005). Choledochotomy increased the length of hospital stay in patients having cystostomy and drainage (P = 0.021) and in those having cystostomy with omentoplasty (P = 0.028). Two recurrences were observed. Surgery combined with medical treatment by albendazole is effective in the eradication of hepatic hydatid disease and in the prevention of local recurrence.