Liver Hydatid Cyst Surgery Research Articles

Lili-Hics trial: Efficacy of the lipid test in liver hydatid cyst surgery.

Bile leakage is a common complication following liver surgeries, particularly in the cases of liver hydatid cyst operations. Currently, there is no adequate method which could be utilized to prevent this complication effectively. Our study aimed to assess the efficacy of the biliary lipid test (BLT) in reducing biliary complications after hydatid cyst surgery. We retrospectively included patients who underwent open liver hydatid cyst surgery between January 2011 and January 2024. The study encompassed 122 patients, with 41 males and 81 females, ranging in age from 18 to 79 years. In the BLT group, a lipid solution was injected transcystically after cholecystectomy. The BLT was performed on 65 patients, while 57 patients did not undergo the test. Following the transcystic injection of the lipid solution, orifices at the site of lipid droplets that became visible were ligated with 5.0 prolene sutures. A total of 200 leak sites were sutured. Remarkably, none of the patients in the BLT group experienced postoperative bile leakage lasting longer than one week. Consequently, a shorter hospital stay was observed in this group. Transcystic injection of the lipid solution with distal clamping effectively demonstrated leak sites, and suturing these sites prevented postoperative bile leakage. Our study demonstrates the effectiveness of the LIpid test in LIver Hydatid Cyst Surgery (Lili-Hics) in reducing biliary complications following hydatid cyst surgery.

Management of Liver Hydatid Cysts: A Retrospective Analysis of 293 Surgical Cases from Southern Iran.

The current study aimed to evaluate the therapeutic features and complications of liver hydatid cyst in patients who underwent surgery for cystic echinococcosis (CE) in Fars province, southern Iran. A total of 293 patients who underwent surgery for liver hydatid cyst from 2004 to 2018 in Fars province, southern Iran, were retrospectively evaluated. The clinical records of patients were reviewed, and the demographic and clinical characteristics of each patient were assessed. Of the total of 293 cases, 178 (60.9%) were females and 115 (39.1%) were males. The mean age of the subjects was 37.22 (±20.55) years. The mean size of the liver hydatid cyst was 9.18 (±4.365) cm. Of the 293 patients studied, 227 (77.4%) had hydatid cysts only in the liver, while 55 (9.4%) had both liver and lung cysts. More than half of the liver cysts (65.9%) were located in the right portion of the liver (segment 5 to 8). Of the 293 cases, 52 (17.7%) underwent radical surgery, while 241 (82.3%) underwent conservative surgery. Recurrence of hydatid cyst was recorded in 46 (15%) of cases. Patients who were treated with radical surgery in comparison with those who had conservative surgery had a lower recurrence rate but a longer duration of hospital stay (P < 0.05). Recurrence remains as one of the major challenges in the management of hydatid cyst. Radical surgery reduces the chance of recurrence, although this procedure increases the length of hospital stay.

Atypically Located Hydatid Cyst Cases: Four Unusual Case Reports

Hydatid cysts are frequently located in liver (65-70%) and lungs (25%). The disease is usually asymptomatic when located in the extrahepatic regions. Sometimes, diagnosis can be established by observing germinative membrane, rockwater, or daughter vesicles during the operation.. A 41-year-old female patient applied with the complaint of intermittent left inguinal pain. Echinococcus Indirect Hemagglutination (IHA) test was positive. In the ultrasonographic examination, a hypoechoic area was observed in the posteromedial of the left femoral head.. A 56-year-old female patient, applied with the complaints of intermittent nausea, vomiting, and epigastric pain. She had a history of surgery for liver hydatid cyst 15 years ago and for lung hydatid cyst 10 years ago. IHA test of the patient was positive. The lesion involving septation and accompanied by calcifications around the cyst was reported as a hydatid cyst at dynamic CT for pancreas and upper abdominal MRI. A 22-year-old female patient applied with perianal pain complaint. Drainage was planned for the patient who had a pre-diagnosis of perianal abscess. Tissues similar to the hydatid cyst membrane were excised together with purulent fluid. The patient was diagnosed with hydatid cyst after the pathology result was reported “as compatible with hydatid cyst”. A 32-year-old female patient had a non-metabolic adrenal subcapsular cyst (hydatid cyst?) in the right adrenal gland on ultrasonography performed for abdominal pain. In abdominal tomography, a “cystic mass compatible with hydatid cyst located in the adrenal gland in the upper pole of the right kidney” was reported. IHA test of the patient was negative. Hydatid cysts located in the perianal region and muscles have been reported as atypical localizations in the literature, and some of them were diagnosed as a result of preoperative clinical evaluation and radiological imaging. Some were diagnosed as a result of pathological examination after the operation. Surgical treatment is an option in suitable cases, and the definitive diagnosis can be established by pathology. Consequently, it should be considered that cystic lesions detected in the patients living in endemic regions can be extrahepatic hydatid cyst that is localized in different anatomical regions.

Postoperative morbidity risk factors after conservative surgery of hydatic cyst of the liver: a retrospective study of 151 hydatic cysts of the liver

BackgroundThe purpose of the present paper is to assess the morbidity specifics risk factors of hepatic hydatid cyst after conservative surgery.MethodsWe conducted a retrospective study of 102 patients over a period of 13 years, from 2006 to 2019. We included all patients operated on hydatid cyst of the liver, complicated and uncomplicated, in the Department of General Surgery in Tahar Sfar hospital, Mahdia, Tunisia. We excluded patients who received an exclusive medical treatment and those who have other hydatic cyst localizations.ResultsThe cohort was composed of 102 patients with a total of 151 cysts operated on using conservative surgery, among them there was 75 women (73.5%) and 27 men (26.5%). The median age was 43, with extremes ranging from 12 to 88 years. The majority of patients (94.1%) were from rural areas. The cysts were uncomplicated in about half of the cases (48%), elsewhere complications such as compression of neighboring organs (25.5%), opening in the bile ducts (16.7%), infection (9.8%), and rupture in the peritoneum (2%) were found. Conservative surgery was the mainstay of treatment with an overall mortality rate of 1.9%. The overall morbidity rate was 22%: 14% specific morbidity and 8% non-specific morbidity. External biliary fistula was the most common postoperative complication (9%). The predictive factors of morbidity in univariate analysis were: preoperative hydatid cyst infection (P = 0.01), Compressive cysts (P = 0.05), preoperative fever and jaundice, (respectively P = 0.03 and P = 0.02), no one achieved statistical significance in the multivariate model.ConclusionsPreoperative hydatid cyst infection, compressive cysts and preoperative fever and jaundice could be predictor factors of morbidity after conservative surgery for liver hydatid cyst. They must be considered in the treatment and the surgical decision for patients with hydatid cyst.

Risk factors determining bile leakage after multiple liver hydatid cyst surgery

Background/Aim: Biliary leaks are the main source of morbidity after liver hydatid cyst surgery. Many identified factors have been examined in predicting biliary leaks. The aim of this study was to determine the postoperative bile leakage rate and predictive factors affecting bile leakage in multiple liver hydatid cysts. Method: In our retrospective cohort study, the data of 130 patients who underwent multiple liver hydatid surgery in our clinic between January 2007 and November 2013 were analyzed. Results: In the 130 patients with multiple cysts, 323 hydatid cysts were detected. The number of cysts was 2 in 65.4% of the patients, and 3 or more in 34.6% of the patients. The postoperative bile leakage rate was 19.2%. According to the univariate analyses, during the preoperative period, the presence of jaundice, fever, leukocytosis, eosinophilia, aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, alkaline phosphatase, and direct bilirubin increase, the largest cyst being located in the perihilar region, the mean diameter of the cyst, the diameter of the largest cyst, biliary tract dilatation on the preoperative images, and infection were associated with increased postoperative bile leakage. In the multivariate analyses, eosinophilia and biliary tract dilatation on the preoperative images were found to be independent risk factors for postoperative bile leakage. Conclusion: In this study, the most determining factors for bile leakage after multiple liver hydatid cyst surgery were a high eosinophil rate and the presence of dilatation in the biliary tract on the preoperative radiological images.

The pigtail stenting treatment for the Biliary leakage After the Liver hydatid cyst operation: A case report

Echinococcus granulosis commonly involve the liver and are mostly seen in Turkey . One of the early complication following the surgery for liver hydatid cyst is biliary leakage (B.L.) which’s incidence is %4.5-26. Endoscopic sphincterotomy (E.S.) and biliary stenting are usually successful in treating B.L. In this case, I’m presenting endoscopic treatment for the B.L. after the liver hydatid cyst operation.

Outcome of Biliary Fistula After Liver Hydatid Cyst SurgeryHydatid cyst, biliary fistulae, Outcome, surgery.

Background: Biliary fistula after liver hydatid cyst surgery was occur in about 17.8 percent of patients inour center.Objective: To study the outcome of biliary fistula regarding factors related to its causes and management.Patients and Methodology: This is a prospective study of 241cases submitted to liver hydatid surgery inAl-Sader teaching hospital in Al-Najaf city, from October 2015 to April 2019. A total of 43 patients whounderwent surgery complicated with persistent leakage of bile from externaldrain. Prospectively collecteddatabase were gathered from patients medical records,sent for essential investigations, and treated eitherconservatively to give a chance for spontaneous closure, or by intervention with ERCP.Results: Forty three patients who develop postoperative biliary fistula after hydatid cyst surgery from 241patients(17,8 %),230 patients treated with conservative surgery (95,4 %), 2 patients treated with radicalsurgery(0,82 %) and 9 patients treated with percutaneous aspiration injection reaspiration (3.7%).All the 43patients in this search treated with conservative surgery. Size more than 15 cm is a risk factors. Intraoperativerisk factor is mainly presence of cystobiliary communication which occur in 16 patients (37,2%). Treatment;isconservative in about 23 patients(53.4%).Treatment with ERCP in 19 patients (44.1%).Time of interventionis from 9 – 15 days.Conclusion: Most of patient with external biliary fistula after hydatid liver surgery can be treatedconservatively and resolve spontaneously specially low output fistula.

Radical surgery in hepatic hydatidosis: analysis of results in an endemic area.

radical surgery in hepatic hydatidosis is associated with less morbidity and recurrence than conservative surgery. a retrospective observational study of patients with liver hydatid cyst surgery was performed. Seventy-one patients with 90 cysts were included between 2007 and 2017, and radical surgery was performed in 69.01 %. there was no difference in morbidity, mortality, biliary leakage or recurrence according to surgery. Complicated cysts were associated with a longer hospital stay and morbidity. decision-making should consider age, comorbidity, cyst characteristics and available resources. Radical surgery should be applied whenever feasible as it achieves better results with an adequate selection of patients.

Retrospective Review of Complications of Liver Hydatid Cyst Surgery with Emphasis on Outcomes of Omentoplasty.

Background:The outcome and complications of liver hydatid cyst surgeries with new and old techniques are not well determined. We intended to present the results of operations done for patients with hepatic hydatid cyst in an endemic area.Methods:Data of 112 patients referred and operated for liver hydatid cyst, in Imam Khomeini Hospital complex, Tehran, Iran, from 2015 to 2018, were collected including demographic characteristics, operation parameters and complication related statistics. The variables were presented for different surgical methods including operations with and without omentoplasty.Results:Patients aged 39. 3 ± 13. 9 yr (70 females; 63. 5%). Most frequent clinical complaint was vague abdominal pain (n=45; 40. 2%). The most prevalent comorbidity was hypertension (18; 16.0%). Conservative methods were chosen more frequently including omentoplasty (44; 39. 3%), cyst drainage (27; 24. 1%), cyst resection (19; 17%) and marsupialization (3; 2. 7%). Overall, 56 patients (50%) were operated with omentoplasty as the single method or in combination with segmentectomy. Complications occurred less in patients operated with omentoplasty (41. 1 vs. 23. 2%; P=0. 043); particularly, biloma was more frequent in surgeries without omentoplasty (7. 1 vs 0. 0%; P=0. 042). Persistence and recurrence rates were 12. 5% and 3. 6% with relative predilection in, respectively, segmentectomy and lobectomy surgical methods compared to Omentoplasty. No mortality was recorded.Conclusions:In our case series of hepatic hydatid cyst patients, omentoplasty was safe with less complication and similar long-term recurrence rate.

Portal Cavernoma Complicating a Persistent Postoperative Bile Leak after Liver Hydatid Cyst Surgery: -a Report Case-

INTRODUCTION: Hydatid cyst is a parasitic infection caused by the larval form of Echinococcus granulosis. Portal hypertension is an unusual postoperative complication after a liver hydatid cyst surgery. CASE PRESENTATION: To illustrate this rare condition, we present the case of a 32-year-old patient operated for a liver hydatid cyst with late-onset postoperative complications. The patient suffered from secondary digestive bleeding because of portal hypertension and was therefore treated with a distal splenorenal shunt (Warren). CONCLUSION: Surgery of hydatid cyst may cause severe complications like portal hypertension and in certain cases, distal splenorenal anastomosis might represent an important treatment option that needs to be performed in specialised centres. Keywords: Liver cyst, Portal hypertension, Splenorenal shunt.

A retrospective study of hydatid cysts in patients undergoing liver and lung surgery in Tehran, Iran

Hydatid cyst, caused by larval stages of Echinococcus granulosus, is a zoonotic parasitic disease with public health importance. The disease is cosmopolitan and endemic in Iran. We conducted a retrospective study of the records of Milad Hospital, Tehran, Iran to establish the proportion of lung and liver surgical procedures that were performed for removal of hydatid cyst and to investigate the demography of the population undergoing lung and liver hydatid cyst surgery in this hospital. A retrospective cross-sectional study was conducted of records of 682 patients who underwent liver (n = 404) or lung (n = 278) surgery from April 2009 to March 2013. In 404 liver surgeries, 111 (27.5%) diagnoses of hydatid cyst were verified. Liver hydatid infection demonstrated a significant age-related difference (p < 0.05). Cysts were found in 64 of 217 females (29.5%) and 47 of 187 males (25.1%). While in both sexes, more cysts were found in liver, the liver/lung ratio in females was significantly higher than in males (p < 0.001). Hydatid cyst was verified in 59 (21.2%) of 278 lung surgeries: 27 of 105 females (25.7%) and 32 of 173 males (18.5%). There was a significant relationship between sex and organ site (p < 0.001) with the proportion of hydatid cysts in males occurring in lung higher than seen in females. In the five investigated years, approximately 25% of liver and lung surgeries conducted at Milad Hospital were related to hydatidosis. Increasing public awareness of principles of avoiding infection could reduce the risk of nearly a quarter of liver and lung surgeries and costs associated with the treatment of hydatid cysts.

Retrospective analysis of risk factors for development of biliary fistula after liver cyst hydatid surgery

Aim: Hepatic hydatidosis is common parasitosis in Turkey and caused by Echinococcus granulosus. Biliary fistula is the most common complication after liver hydatid cyst surgery. The aim of this study was to investigate an appropriate treatment strategy for patients whose biliary fistula might develop, by revealing variables that affect biliary fistula.Methods: A total of 118 patients who underwent liver hydatid cyst surgery were included in this study. The following variables were analyzed between patients with biliary fistula (group 2) and without fistula (group 1): Age, gender, hematologic and liver function tests, and features of the cysts (type, cyst size, number, and localization).Results: Cystobiliary fistula was detected in 19 (16%) of 118 patients. In-group 2, cyst size, white blood cell, alkaline phosphatase and g-Glutamyl transpeptidase levels were higher than group 1 on univariate analysis (p=0.03, p=0.008, p=0.04 and p=0.001, respectively). In the multivariate model, only cyst diameter remained as an independent predictor (odds ratio 0.03, 95% confidence interval 0.002 to 0.06; p=0.03) On the receiver operating characteristic curve, the 100% sensitive, 100% specific, and optimal cutoffs of the cyst diameter were 7.5 cm, 4.0 cm and14.6 cm, respectively (The area under the receiver operator characteristic curve was 0.67). Conclusion: Preoperative cyst size is a valuable parameter for predicting biliary fistula. Our study suggests that cyst size greater than 7.5 cm is a risk factor for biliary fistula.

Effect of cyst volume and other risk factors on biliary leak following liver hydatid cyst surgery

Aim: This study aimed to determine the effect of prognostic factors indicating the presence of cystobiliary communication in the preoperative period and volume values obtained using the magnetic resonance imaging technique on the rate of biliary leak. Material and Methods: Twenty-six patients surgically treated for hydatid disease were included in the study. Age, sex, number, localization, volume and size of cysts, and liver function test results were statistically compared between the patients with and without biliary leak. Results: There were no significant differences between the groups with respect to age, gender, and number, volume and localization of cysts (p>0.05). However, a significant difference was found concerning the increase in liver function test results and cystobiliary relationship (p

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Aim: The biliary fistula development after liver hydatid cyst surgery is a common complication. The aim of this study is to examine the factors affecting the development of postoperative biliary fistula in patients operated for liver hydatid disease. Methods: The study was retrospectively performed in patients treated surgically for liver hydatid cyst between 1999 and 2010. The data of 53 patients operated for hydatid csyt were reviewed with hospital records. Patients were divided into two groups as biliary fistulas with (Group A) and without biliary fistula (Group B). The demographic data (age, sex), cyst diameter, cyst localization, laboratory tests and length of hospital stay were recorded. These parameters were compared with the groups.Results: The groups were similar in terms of age and sex (p = 0.790 and p=1.0, respectively). In group A, the mean cyst diameter was significantly higher than group B (p=0.001). The mean duration of hospitalization was longer in group A than group B (p=0.001). There was no difference between the groups considering cyst localization, AST, ALT, total bilirubin and direct bilirubin (p&amp;gt;0.05 for all). Conclusion: Preoperative cyst diameter may be a valuable parameter for predicting biliary fistula preoperatively. However, larger prospective studies are needed on this subject.

Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst

Biliary leakage (BL) is the most common cause of postoperative morbidity after conservative liver hydatid cyst surgery. The objective of this study was to determine incidence of BL and related risk factors in patients with solitary liver hydatid cyst who underwent conservative surgery. A total of 186 patients were included in this study. Age, gender, cyst recurrence, diameter, and localization, World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification, cavity management techniques, cyst content, and alkaline phosphatase (ALP) levels were evaluated with univariate and multivariate analyses. Of these patients 104 were female and 82 were male. The mean age was 43.5 ± 14.7 years. Postoperative BL was detected in 36 (19.4%) patients. Cyst diameter (P = 0.019), cyst localization (P = 0.007), WHO-IWGE classification (P = 0.017), and ALP level (P = 0.001) were the most significant risk factors for BL. Independent risk factors for BL were perihilar localization, large cyst diameter, high ALP level, and advanced age according to WHO-IWGE classification.

Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver

Background and study aimsHepatic hydatid cyst is a major health problem in endemic areas. Surgery is still the best choice for treatment of the hydatid cyst of the liver. However, it is still associated with high mortality and morbidity.The aim of the study was to evaluate the predictive factors for specific morbidity after conservative surgical treatment of the hydatid cyst of the liver. Patients and methodsA total of 120 patients who underwent conservative surgical treatment between 2001 and 2011 were evaluated retrospectively. ResultsOf the 120 patients, 64 were female subjects and 56 male subjects; the median age was 33years (14–83years). The mortality rate was 0%. The overall morbidity rate was 26.6%. The specific morbidity rate was 16.6%. The major specific complications were infection of the residual cavity in 10 cases and an external biliary fistula in eight cases. The predictive factors of morbidity in univariate analysis were bilious cyst content, location of the cyst in the hepatic dome, and size >10cm. After multivariate analysis, only the size of the cyst was an independent predictive factor of morbidity. ConclusionThe size of the cyst was the significant predictor of morbidity of conservative surgery for liver hydatid cyst.

Does Primary Surgical Management of Liver Hydatid Cyst Influence Recurrence?

Background and aimsHydatid disease is still a major health problem in sheep-raising areas. Surgery remains the basic treatment for liver hydatid cyst (LHC). However, recurrences can occur after all therapies. Surgery for recurrence of LHC becomes technically more difficult with higher rate of morbidity and mortality. The aim of this study was to determine perfective factors associated to hepatic recurrence after LHC surgery and to propose and discuss postoperative follow-up schedules. MethodsIt is a retrospective cohort study of 672 patients with LHC treated at the surgery department “A” at Ibn Sina University Hospital, Rabat, Morocco, from January 1990 to December 2004. Recurrence rates have been analyzed by the Kaplan–Meier method for patients undergoing surgery. ResultsFifty-six patients (8.5%) had LHC recurrence after surgery. There were 34 females (60.7%) and 22 males (39.3%). Median duration of recurrence's diagnosis was 24 months (interquartile range: 10–48 months). Recurrence's risk was 2.3% ± 0.6% at 1 year and 9.1% ± 1.3% at the 10th year. The history of LHC (hazard ratio, 2; 95% confidential interval, 1.13–3.59) and three cysts or more (hazard ratio, 3.8; 95% confidential interval, 2.07–6.98) was an independent risk factor for recurrence. ConclusionWe think that the surgeon's practice and experience are the most important to success the surgical treatment. It prevents complications and recurrences.

Predictors of morbidity and mortality in the surgical management of hydatid cyst of the liver

Surgery for hydatid cyst of the liver is widely practiced worldwide; this type of management is still associated with high mortality and morbidity. The aim of this study is to find out possible predictors for this high mortality and morbidity. The medical records of 169 patients who underwent surgery for hydatid cyst of the liver were retrospectively reviewed. The mortality and the morbidity rates were assessed as well as the following eight potential predictors of mortality and morbidity: age of the patients, size of the cyst, number of cysts, other organs involved by the disease, the presence of preoperative complications, the type of surgery performed (radical or conservative), whether the disease was new or recurrent, and when surgery was performed in the first period (1973-1986) or in the second period (1987-1999). Cross-tabulation and logistic regression between mortality and morbidity (dependent variable) and the above-mentioned eight potential predictors (independent variables) were carried out. Of the 169 patients, 112 were female subjects and 57 male subjects, the age range was from 5 to 85 years (mean=39.2 years), the mortality rate was 6.5% (n=11), and the overall morbidity rate was 53.8% (n=91), while specific complications of liver hydatid cyst surgery were seen in 32% (n=54). Patients of age >40 years, with a cyst diameter of >10 cm, who presented with pre-operative complications, who had conservative surgery, and who had surgery before 1987 were having a significantly higher mortality and morbidity rate. Age, size of the cyst, the presence of pre-operative complications particularly cyst-biliary communication, and type of surgical procedure performed (conservative or radical) represent as significant predictors of mortality and morbidity of surgery for liver hydatid cyst.