Surgical Treatment Of Hydatid Cyst Research Articles

Surgical Treatment of Hydatid Cyst of Lung; An Experience at Lady Reading Hospital Peshawar

Objective: To evaluate the surgical treatment options for hydatid cyst and their outcomes.
 Study Design: Cross-sectional analytical research.
 Place and Duration of Study: Department of Surgery of Lady Reading Hospital, Peshawar, from Jan 2017 to Dec 2020.
 Methodology: Patients diagnosed and treated for hydatid cyst with pulmonary echinococcosis and operated were included. Inhospital as well as hospital records of 180 patients including intact and complicated cysts ranging from 1-20cm in size that were extirpated and included. Patients diagnosed and treated for hydatid cyst having incomplete medical record and /or lost to follow up were excluded. SPSS version 25.0 was used for data analysis. Quantitative variables were reported using mean and standard deviation while qualitative variables through frequency and percentages. Independent students’ t-test and Fisher’s exact test was used for comparing between the surgical technique groups keeping p-value <0.05 as statistically significant.
 Results: Mean age of patients was 38.59±12.51 years. Mean duration of hospital stay was 11.3±6.1 days. Mean pain on VAS postoperatively was 4.92±2.66. About 102(56.67%) of included patients were male while 78(43.33%) females. Cough was reported in 84(46.67%) of patients, chest pain in 103(57.22%), fever in 24(13.33%), purulent sputum in 31(17.22%), allergic reaction in 17(9.44%), hemoptysis in 4(2.22%) while 29(16.11%) were asymptomatic. About 58% of cases underwent cystotomy and capitonnage, 17% enucleation and capitonnage while 12% pericystectomy, 4% cystotomy and wedge resection and segmentectomy respectively, 3% lobectomy and pneumonectomy in 2% of cases.
 Conclusion: Every surgical approach reported varied outcomes, however the best efficacy with least morbidity and mortality was observed in patients undergoing cystotomy and capitonnage.

Hydatid cysts of the liver opening in the biliary tracts: about 120 cases comparative study between radical and conservative treatment

Background. Hepatic hydatid disease is still common in Tunisia, is deemed benign disease but concerns its complications; the most frequent is the rupture in biliary ducts. The aim of the work was to study the results of surgical treatment of hydatid cysts of the open liver in the bile ducts and to deduce the predictive factors of postoperative complications. Methods. This was a retrospective study, done in the department of general surgery of Mongi Slim hospital, over a period of 11 years (from January 2000 to December 2013) and collecting 115 patients. Judging criteria were specific morbidity, length of postoperative stay and recurrence. Results. The median age was 43 years (62 women and 53 men). The clinic consisted of typical cholangitis episodes (6.95%), 6.95% of patients were asymptomatic. 50 radical interventions and 65 conservative interventions were performed, supplemented by treatment of the fistula as follows: Fistula blindness (43.47%), trans-fistulo-oddian drainage (3.4%), bipolar drainage (2.6%), PERDOMO (6.95%). The overall mortality was zero. The overall morbidity was 27.69% with an overall specific morality of 14.7% mainly represented by the suppuration of the CR and the external biliary fistulas. The median postoperative stay was 6 days; the recurrence rate was 1.7% with a delay of 30 months. The predictive factors of postoperative complications in bi variance were: The size of the cyst (p = 0.02), The location of a cyst in the hepatic dome (p = 0.002), Surgical treatment: radical or conservative (p = 0.02), The sex factor (p = 0.015). The multivariate study who found a significant association between sex only and postoperative complications. Conclusion. Advances in hepatobiliary surgery and anesthesia are changing the surgical attitude in favor of radical procedures with favorable consequences in terms of morbidity, length of stay and recurrence. It is believed that the surgeon’s experience is the most important factor in the success of surgical treatment. This helps to prevent complications.

Mabit’s technique for hydatidosis. A centennary revisit

The paper published by Sebastián Mabit in France describing what he called his technique for the surgical treatment of hydatid cysts, and the previous thesis of one of its trainees, share a group of patients operated by Mabit in the Hospital Francés of Buenos Aires at the end of the 19th century. There are some doubts about the origin of such technique due to differences in the description of the operations. These differences are described below.

In vitro Scolicidal Effect of Ginger (Zingiber officinale Roscoe) Ethanolic Extract Against Protoscolices of Hydatid Cyst

Background: To prevent the recurrence of hydatid cysts after surgery, it is essential to use effective scolicidal agents. Most of these agents are not safe due to their undesired side effects. Recently, studies have been conducted to find natural scolicidal agents with more efficacies and low side effects. OBJECTIVES: In this study, the in vitro scolicidal effect of ethanolic extract of ginger (Z.officinale) on protoscolices of hydatid cyst was investigated. METHODS: A certain number of protoscolices (about 500) were treated with various concentrations of ginger ethanolic extract (40, 50, 100, 150 and 200 mg/ml) and the effect of each concentration was evaluated for specified time periods (15, 30, 45 and 60 minutes). Each concentration/time was performed in triplicate and the viability of protoscolices was confirmed by 0.1% eosin staining. RESULTS: The mortality rate with ethanolic extract of Z.officinale after 60 minutes was as follows: 68%, 92.3%, 93% and 100% at 50, 100, 150 and 200 mg/ml, respectively, and there was no significant difference between the three concentrations of 200, 150 and 100 mg/ml (P>0.05). However, at the concentrations of 200 mg/ml after 30 minutes of incubation, 100% protoscolices were dead. Based on Tukey’s test, a significant difference in the percentage of live protoscolices was found between the different concentrations of ginger extract with the exception of between 150 and 100 mg/ml concentrations (P>0.05). CONCLUSIONS: Ethanolic extract of Zingiber officinale had a high scolicidal activity in vitro, and it has the potential to be used as a scolicidal agent in the surgical treatment of hydatid cysts.

Solidification of hydatid cyst fluid with an injectable chitosan/carboxymethylcellulose/\u03b2-glycerophosphate hydrogel for effective control of spillage during aspiration of hydatid cysts

Cystic echinococcosis (CE)/hydatid cyst is one of the most important helminthic diseases in the world. The treatment of hydatid cyst ranges from surgical intervention to chemotherapy, although the efficacy of chemotherapy is still unclear. Postoperative complication which results from the spillage of cysts during surgical operation is one of the most important concerns in surgical treatment of hydatid cyst. The aim of the current study was to solidify the hydatid cyst fluid (HCF) with an injectable and thermosensitive chitosan (CS)/carboxymethyl cellulose (CMC)/β-glycerol phosphate (BGP) hydrogel for effective control of spillage during the aspiration of hydatid cysts. Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), water uptake, rheological analysis, and Alamar Blue cytotoxicity assay were employed to characterize the hydrogel. A five level with three times replication at the central point using a central composite design (CCD), which is a response surface methodology (RSM), was used to optimize the experimental conditions. Assessment of the produced hydrogel showed that the intermolecular interactions of amino groups of chitosan and hydrogen groups of CMC were correctively established and appreciable swelling with a good strength was obtained. Hydrogels morphology had a porous structure. Rheological analysis showed that CS/CMC/BGP blends had a phase transition (32–35 °C) of sol–gel close to the body temperature. Alamar Blue cytotoxicity assay showed that CS (1.75%)/CMC (1.4%)/BGP (2.9%) had IC50 values of 0.598, 0.235 and 0.138 (µg/µL) for 24, 48 and 72 h, which indicated that the produced polymer solution had no significant cytotoxic effect for human fibroblast cell line. In vitro injection of the polymer solution of CS/CMC/BGP with CS/CMC ratio of 1.75/1.4 was done on HCF (1 mL polymer solution to 3 mL of HCF) at 37 °C with a final concentration of 2.9% for BGP resulting in solidification of HCF in less than 45 min.

Comparative evaluation of computer assisted surgery of cystectomy of children’s liver

Objective: a comparative evaluation of the results of the nearest postoperative period assisted surgery and the traditional methods of treatment of hepatic echinococcosis in children. Methods. Based on the results of treatment of 92 children with hepatic echinococcosis, treated in the clinic of pediatric surgery in West Kazakhstan medical University named after Marat Ospanov in the period from 2014 to 2017. In the surgical treatment of hydatid cysts of the liver methods of endovideosurgery was used in 63 children (the main group) and open cystectomy liver in 29 children (comparison group). The dynamics of the patients with echinococcosis of the liver in the immediate postoperative period after endovideosurgical and open cystectomy were evaluated by the following criteria: the terms of relief of pain syndrome (was used a numerical rating scale of pain assessment), the timing of normalization of body temperature and peripheral blood, timing of restoration of function of the gastrointestinal tract, the length of stay of patients in the intensive care unit, timing of recovery of motor activity, timing of removal of drains from the abdominal cavity, the length of hospital stay. Results. The dynamics of the patients in the nearest postoperative period after cystectomy assisted surgery of the liver showed that in earlier periods was the relief of pain, normalization of body temperature, peripheral blood, restoration of the gastrointestinal tract, decreased length of stay in the intensive care unit, recovery of motor activity, at an earlier date removed drainage of the abdominal cavity, decreased time of inpatient treatment. Recurrence of the disease was not. Conclusion: Comparative evaluation of computer assisted surgery is cystectomy in conjunction with lymphotropic therapy with an open echinococcectomy showed less invasiveness of endovideosurgical technology, high efciency and ability to perform echinococcectomy of the front not only localization, but also posterior-diaphragmatic. Carried out lymphotropic therapy contributes to a softer postoperative period.

СОВЕРШЕНСТВОВАНИЕ ДИАГНОСТИКИ И ЛЕЧЕНИЯ РАЗЛИЧНЫХ МОРФОЛОГИЧЕСКИХ ФОРМ ЭХИНОКОККОЗА ПЕЧЕНИ

Summary . The Objective of the work was to find ways to optimize the diagnostic and therapeutic measures in patients with hepatic echinococcosis in view of the morphological forms of parasitic cysts. The study is based on a study of the results of the application of different options for surgical interventions in the treatment of 305 patients with liver echinococcosis. All patients in the last 10 years (2005–2015) have been treated in the II Clinic of Samarkand State Medical Institute. Postoperative complications were observed in 35 (11.5 %) patients, postoperative mortality was noted in 1 (0.3 %) cases. Echinococcosis Relapse occurred in 17 of 236 patients observed in the long term (77.4 %). The results of surgical treatment of hydatid cysts of the liver are largely dependent on a differentiated approach to the choice of an adequate method of surgical treatment, taking into account morphological form cyst and the principles aparazitarnosti and anti-parasitic. In the late period of echinococcosis recurrence was observed in 2.9 % of patients operated on for complicated echinococcosis, and in 4.2 % of patients who refused chemotherapy postoperatively. Key words : еchinococcosis of the liver, morphological forms, diagnosis, treatment.

Surgical treatment of hydatid cysts with large biliocystic fistula results from a monocentric surgical experience

Background: Hydatid cyst opened in the biliary tract constitutes an evolutionary turning point in the hydatid disease and risks to be life-threatening. Liver hydatid cysts with large biliocystic fistula is defined by the presence of a biliocystic fistula which is more than 5 mm in diameter and / or the presence of hydatid material in the common bile duct. The diversity of the pathological lesions of this disease and the lack of randomized controlled trials studying the different therapeutic techniques make those attitudes varied and sometimes debated. The purpose of this study was to study the different therapeutic possibilities as well as the difficulties posed by the large biliocystic fistula.Methods: This is a retrospective study of all consecutive patients (n=51), operated on for liver hydatid cysts with a large biliocystic fistula, between January 2003 and December 2012. The average age in this series was 39 years. There were 21 men and 30 women. An acute cholangitis was present in 47% of cases.Results: The treatment of hydatid cyst was conservative (cyst unroofing) in 90% of cases and radical in 10% of cases. The large biliocystic fistula was treated by internal transfistulary drainage (21%), cystobiliary disconnection by trans-parieto-hepatocystic fistulisazion (35%), bipolar drainage (25%), direct suture of the fistula (8%) and liver resection (10%). The specific morbidity rate was 27% (n = 14). No deaths have been observed. The average follow-up was 22 months. Six cases of recurrence were observed.Conclusions: The treatment of intrabiliary rupture of echinococcal cysts is not consensual. The internal transfistulary drainage and the transparietohepatocystic fistulization represent the techniques of choice in case of conservative surgery. Prevention remains the best treatment.

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.

Torakal yaklaşım ile akciğer, karaciğer ve dalak kist hidatiklerinin cerrahi tedavisi

Torakal yaklaşım ile akciğer, karaciğer ve dalak kist hidatiklerinin cerrahi tedavisi

Comparison of the Protoscolocidal Effectiveness of Hypertonic Saline, Povidone—Iodine and Albendazole Solutions in an Experimental Lung Hydatid Cyst Model

Secondary hydatidosis is an important problem encountered during the surgical treatment of hydatid cysts. This study describes an experimental model of secondary hydatidosis by cyst inoculation, used to explore whether simultaneous inoculation of protoscolocidal agents could prevent secondary hydatidosis. Fertile cyst fluid was injected into the pleural space of rabbits alone (group 1, n = 8), and in combination with 2% albendazole solution (group 2, n = 8), 20% hypertonic saline (group 3, n = 8) or 10% povidone-iodine (group 4, n = 8). Computed tomography imaging of the thorax, indirect haemagglutination (IHA) titres and eosinophil counts were used to determine cyst development. After 16 months, three control rabbits had pneumothorax, seven had cysts and four had parenchymal nodules. Histopathological investigation of nodules revealed 87.5% cyst formation. Pleural thickening was observed in rabbits from all groups. Cyst formation rates, IHA titres and eosinophilia counts were higher in group 1 than in groups 2-4. This study demonstrated the experimental formation of secondary hydatidosis and found that topical protoscolocidal agents were beneficial in preventing cyst recurrence.

The Effect of Hepatic Hydatid Cysts on the Size of Spleen

ABSTRACT No previous study has yet reported the effects of surgical treatment of hydatid cysts on spleen volume. Our aim was to use computed tomography images to evaluate the volume differences in the spleen in postoperative periods in patients who had undergone operations for hydatid cysts. The abdominal computed tomography scans of 20 patients who had undergone drainage of a hydatid cyst and omentopexy operation were examined retrospectively. The volume of the liver, the cyst, and the spleen were estimated using the Cavalieri principle of stereological methods. The volume fraction of the hydatid cyst to the liver was also estimated using the obtained volume data. The volumes of the spleen (± SD) were 302.0 ± 115.1 cm3 and 259.5±82.4 cm3 in the postoperative 1st week and 6 months, respectively (p 0.05). The volume of spleen decreased after hydatid cyst surgery. This may be due to the decreased portal venous pressure of the liver. Additionally, the loss of immune stimulation may have resulted in reduction in splenic volume. Our results also indicated that stereological methods can be used to monitor volume changes of the liver and spleen. J. Exp. Clin. Med., 2011; 28:8-11

Application of laparoscopy in surgical treatment of hydatid cyst

From PubMed and CNKI medical litera-ture, To review and commentate laparoscopic surgery in trentment of hepatic hydatid disease. Since 1991, Laparo-scopic Hepatectomy is located basic period, but all kinds of laparoscopic surgery in treating hepatic hydatid cysts begin to develop completely in treating hepatic hydatid cysts. L-PAIR ( Laparoscopic puncture-aspiration-injection-reaspira-tion)had laid the foundation of course of events, Laparoscopic cholecystectomy stand out more advantages compared with open opreation. Nowdays,Laparoscopic pericystectomy is be-lieved best way in trentment of hepatic hydatid disease be-cause of Minimally invasion and radical surgery, reveals the most satisfactory effectiveness and wide foreground. Laparo-scopic Hepatectomy is exploratory works because of higher Key words: Laparoscopy; Hydatid cyst; Surgery

More Than 25 Years of Surgical Treatment of Hydatid Cysts in a Nonendemic Area Using the “Frozen Seal” Method

BackgroundHydatid disease of the liver remains endemic in the world and is an imported disease in The Netherlands. The aim of this study was to evaluate the treatment and outcome of surgically treated patients for hydatid disease in a single center in The Netherlands.MethodsThis retrospective study included 112 consecutive patients surgically treated for hydatid disease between 1981 and 2007. The primary outcome was relapse of the disease. Secondary outcomes were infections, complications, reoperations, length of hospital stay, and mortality.ResultsIn all cases, echinococcosis was diagnosed by computed tomography or ultrasonography (US). Serology (enzyme-linked immunosorbent assay, immunofluorescence) confirmed the diagnosis in 92.9%. Most of the cysts were seen only in the liver (73.5%). All cysts were operated on with the frozen seal technique. Relapse of disease was seen in 9 (8.0%) cases. Five (4.5%) required surgical treatment at a later stage. Twenty (17.9%) complications were recorded. Four (3.6%) needed radiological drainage and three (2.7%) a reoperation. Follow-up was performed with US and/or serology at a mean of 24 months (range 0.5–300 months). All but one complication were seen in the liver-operated group, this proved not to be of statistical significance (P = 0.477). Patients with complications stayed significantly longer in hospital than did the patients without complications (P < 0.001). No mortality was observed in this study.ConclusionsThe present study suggests that the frozen seal method of surgery for hydatid disease is safe and effective. Future studies are needed to prove its position in the treatment of hydatid disease as new developments show promising results.

Paraplegia due to recurrent multiple hydatid cyst of the spine: A case report

Recurrence after surgical treatment of hydatid cyst of the spine is extremely common. Preexisting fibrosis, fragility of the cyst wall, confluent cysts and proximity to vital structures makes radical excision difficult and repeated recurrences are inevitable. This case report describes a recurrent hydatid cyst presenting as three separate cysts in the dorsal spine in a middle-aged male. The extradural cyst caused paraplegia. The extraspinal cyst presented as an extrapleural mass in relation with the eighth, ninth and the tenth ribs near the costo-vertebral junction. The three cysts were resected en masse. Complete neurological recovery occurred with no recurrence at four years follow-up. Resection of the hydatid cyst en masse offers the best chance of cure and must be attempted in all cases. A prolonged chemotherapy should be administered in all cases.

In Vitro Effectiveness of Different Chemical Agents on Scolices of Hydatid Cyst

In the surgical history of hepatic hydatid disease, multiple scolicidal agents have been used for sterilization of the cyst contents. However, none of these agents can be safely used, because most have unacceptable side effects, such as toxicity, caustic sclerosing cholangitis, bile duct stricture, and hypernatremia. Protoscolices were aseptically removed from liver hydatid cysts obtained from sheep slaughtered at the municipal abattoir in Kahramanmaras, Turkey. In this study, the effects of 0.9% NaCl (control group), 20% NaCl (hypertonic saline), 20% silver nitrate, albendazole 20 mg/cm3, 50% dextrose (hypertonic glucose), and 20% mannitol and aminomix-1 solutions on echinococe cysts were investigated under in vitro conditions. After 5, 10, 15, 20, 25, 30, 45, and 60 min for each concentration, the first 100 protoscolices were counted on the 10× microscopical field. Protoscolices, which showed positive staining by eosine were considered as dead ones. The averages of dead and total protoscolices were calculated. Our results showed that all observed protoscolices were dead after the treatments by 20% silver nitrate in 20 min, by 50% dextrose and by aminomix-1 solution in 30 min, and by 20% NaCl and by 20% mannitol in 45 min. Albendazole at 20 mg/cm3 was observed to lead to death of 65% of protoscolices in the first 5 min and 70% of protoscolices at the end of 60 min. Compared with 0.9% NaCl (saline), all of these scolicidal agents were significantly effective (p <. 05). Aminomix-1, 20% mannitol, and 50% dextrose solutions may be used in percutaneous and surgical treatment of hydatid cyst. They may be preferred because they are readily available, can be administered intravenously, and have an equal or greater effectiveness than 20% hypertonic saline.

Our results in surgical treatment of hydatid cyst of the lungs

Aim: The cases of pulmonary hydatid cysts are frequently seen especially in Eastern Anatolia Region because the living source is stock-breeding. We aimed to discuss 102 patients operated with the diagnosis of pulmonary hydatid cyst in 2.5 years’ period. The patients with hydatid cyst disease who were applied to our clinic, were evaluated in light of literature. Methods: 102 patients were diagnosed with hydatid cyst clinically and radiologically between June 2002 and January 2005. Their ages ranged between 4-65 years with the mean age of 23 years. Thoracotomy was applied to all patients. Results: Cyst localization was unilateral in 96 and bilateral in 6 of them. 10 patients had also cyst in the liver. Cyst was perforated in 56% of the patients. Enucleation was applied in 3 patients, cystectomy in 3 patients and cystotomy+capitonnage was applied to the remaining. In bilateral cases, operation was applied to the other side after one month from the first operation. Percutaneous drainage was applied in coordination with radiology department in the presence of hepatic hydatid cyst. In these cases and in the presence of multipl cysts, albendazole treatment was applied. Lower lobectomy (2 right, 1 left) was performed in 3 cases. No mortality or recurrence was observed. Conclusion: Cystotomy+capitonnage is still the most valid surgical method in pulmonary hydatid cyst cases because it is a method preserving the parenchyma.

Surgical treatment of hydatid cyst of the liver: Drainage versus Omentoplasty

Background: Liver is the most common site of infection and several methods of surgery have been described to treat this common disease. In this study we aim to compare the results of two common methods of surgery; simple drainage versus omentoplasty. Methods: In this prospective study 65 patients with hepatic hydatid cyst underwent surgery from 10 May 1995 to 1 July 2002. 35 patients were treated with omentoplasty (group I) and 30 of them were treated with drainage (group II). The results of surgery including mortality, complications and recurrences were recorded. Results: There was no case of mortality in each group of patients. Postoperative complications were seen in 5.7% of group I, 16.6% of group II patients. The mean duration of hospital stay was 6.5 and 15.6 days in group I and group II patients. During a mean period of 18.6 month follow up there was no recurrence in each group of patients. Conclusion: According to the results of this study we suppose that omentoplasty of cyst cavity –if feasible– is preferred to tube drainage.

Efficiency of obliteration procedures in the surgical treatment of hydatid cyst of the liver

Hydatid cyst of the liver (HCL) is a parasitic infestation caused by several species of Echinococcus and is endemic in many sheep-raising areas. The aim of the present study is to evaluate the value of clinical, physical and laboratory findings and to discuss the diagnostic and therapeutic options in 250 patients with HCL. Between January 1980 and December 1989, 148 patients with HCL were treated surgically, and surgical procedures performed were evaluated retrospectively. On the basis of these findings, a prospective study of 102 patients was initiated between January 1990 and December 1999. External drainage was performed in retrospective and prospective groups, respectively, in 110 and five patients, obliteration procedures in 31 and 82 and resectional procedures in seven and 15. While mean hospitalization time morbidity, mortality and recurrence rates were 16.2 +/- 6.9 days, 37.8%, 2.0% and 6.7% in the retrospective group, these rates were decreased to 7.8 +/- 3.5 days, 10.7%, 0.9% and 1.9%, respectively, in the prospective group. Overall morbidity, mortality and recurrence rates and median hospitalization time were 49.5%, 2.6%, 9.5% and 18.0 +/- 7.4 days in external drainage group, 7.0%, 0% 0.8% and 8.5 +/- 4.5 in obliteration procedures and 9.0%, 4.5%, 0% and 7.3 +/- 1.9 resectional procedures, respectively. External drainage should be performed only in infected HCL. Resection procedures are too radical and extensive for benign lesions. Obliteration procedures are simple and safe methods for the treatment of HCL, and they have low morbidity, mortality and recurrence rates.

Surgical treatment of hydatid cysts of the liver.

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.