[Results of different surgical methods in management of hepatic hydatidosis]

Abstract

Introduction: Hepatic hydatidosis has been a common pathology for decades in our department. In the past were used different surgical methods to manage liver hydatidosis, but, a method of choice still is not found, especially for treatment of large liver hydatid cysts.

Objective: To analyze the outcome of different surgial methods used for treatment of large hepatic hydatid cysts in our department over a period of 12 years. MATERIAL AND MEDTHODS: A retrospective random chart review of patients with liver hydatid cysts treated surgically during 1981-1990 and 2000-2001.

Results: A total of 183 patients were studied: 110 (60.1% = female, 73 (39.9%) male; the medican age was 37 years (range 17 to 81); the mean preoperative ultrasonographic diameter of cysts was 13.05 cm (median 11.3 cm and maximal 22.3 cm). 72.7% of cysts were localized in the right hepatic lobe and 27.3% in the left hepatic lobe in 21 (11.5%) patients two different cysts in both hepatic lobes were found. Following surgical methods were performed; in 50 (27.3%) patients endocystectomy and capitonnage, in 10 (5.4%) patients external drainage, in 115 (62.8%) endocystectomy and partial pericystectomy with omentoplication according Papadimitris and in 8 (4.4%) opatients complete pericystectomy or atypical liver resection. In 31 (16.9%) choledochal T-tube was placed. Mean postoperative hospital stay was 15.7 days (minimum 5, maximum 71). Overall complication rate was 18.8%, there was no mortality.

Conclusions: Enucleatin of endocysts and partial pericystectomy witzh omentoplication accroding Papadimitris was most often used last years. Endocystectomy with capitonnage as well as external drainage that were used in the past for treatment of large hydatid hepatic cysts, had a more postoperative complications and longer hospital stay compared to the method of Papadimitris.