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. 2008;10(1):18-24.
doi: 10.1080/13651820701854669.

Forty-four years' experience (1963-2006) in the management of primarily infected hydatid cyst of the liver

J Prousalidis  1 , C Kosmidis, G Anthimidis, E Fachantidis, N Harlaftis, H Aletras
Affiliations

Forty-four years' experience (1963-2006) in the management of primarily infected hydatid cyst of the liver

J Prousalidis et al. HPB (Oxford). 2008.

Abstract

Background and aim: The aim of this study was to report our 44-year experience (1963-2006) in the management of primarily infected hydatid cyst of the liver. This is a retrospective review of demographic data, clinical presentation, diagnostic work-up, surgical management, and long-term outcome of patients treated at our center.

Material and methods: There were 77 patients with operated infected liver cysts. In the same period, a total of 460 cases with liver hydatidosis were treated surgically. Of those with suppurated cysts, 27 were men and 50 were women, with a mean age 54.5 years.

Results: Clinical manifestations of an abscess were identified in 75% of the patients. In the earlier cases of the study, the diagnosis was made from the clinical picture, laboratory studies, in combination with plain X-ray, hepatic scintigraphy, and in the later cases with US (ultrasonography), CT (computed tomography) or MRI (magnetic resonance imaging), and ERCP (endoscopic cholangiopangreatography). Abdominal and, rarely, thoracic and abdominal or thoracoabdominal incisions were used. Total cystopericystectomy in 8 patients and partial pericystectomy and proper drainage with one or two drainage tubes of the cystic cavity in the other 69 patients were carried out. Hospital stay was between 13 and 146 days with 5 re-operations. Two patients with grossly suppurated cysts and coexistent medical problems died. The disease recurred in five patients. CONCLUSIONS. We conclude that, under good perioperative antibiotic and metabolic coverage, the infected hydatid cysts have to be completely evacuated and properly drained. The application of "conservative" surgical procedures should be preferred. Further studies are needed to solve the clinical and therapeutic problems of this serious complication.

Keywords: Hepatic echinococcosis; infected hepatic hydatid cyst; liver echinococcosis; liver hydatidosis; primarily suppurated parasitic cysts.

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Figures

Figure 1.
Figure 1.
Appearance of primarily infected hydatid cyst on CT scan.
Figure 2.
Figure 2.
Extended infected hepatic echinococcosis on CT scan.
Figure 3.
Figure 3.
Complete removal of the contents of primarily infected echinococcal cyst.
Figure 4.
Figure 4.
Cystopericystectomy of the primarily infected echinococcal cyst.
Figure 5.
Figure 5.
Opened primarily infected echinococcus cyst.
See this image and copyright information in PMC

References

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