Surgical approach to splenic hydatid cyst: single center experience

Abstract

The benefits and risks of surgery for splenic hydatid cyst (SHC) remain controversial. We aimed to share our experience about a surgical approach for SHC. Sixteen consecutive patients with SHC disease who underwent open splenectomy at our hospital between January 2006 and July 2012 were retrospectively evaluated. Data on the patients' demographic features, clinical findings, radiological and serological diagnostic methods, and surgical and medicinal treatment options were collected and used to generate descriptive profiles of diagnosis, treatment course, and outcome. The patient population was composed of 6 females and 10 males, with an age range of 18 to 79 years (mean age: 47.0 ± 18.0). Radiological examinations detected hydatid cysts in spleen alone (n = 7) or both spleen and liver (n = 9). Preoperative serological testing identified 13 of the patients as IHA positive. All except 1 patient received a 10- to 21-day preoperative course of albendazole therapy and all patients received vaccination 1 week prior to surgery. Seven patients underwent splenectomy. The remaining patients underwent splenectomy with partial cystectomy and omentopexy (n = 6), partial cystectomy and unroofing (n = 1), pericystectomy (n = 1), or pericystectomy with partial nephrectomy (n = 1). All except one patient received a 10- to 45-day postoperative course of albendazole. No patients developed serious complications or signs of recurrence during the follow-up. The clinical profile of SHC disease at our hospital includes diagnosis by radiological methods, splenectomy treatment by simple or concomitant procedures according to the patient's symptoms, cyst size, number and localization, and compression of adjacent organs, and adjunct vaccination to decrease risk of postoperative septic complications. This profile is associated with low risk of complications and high therapeutic efficacy.

Fig. 1

A 39-year-old male patient with splenic hydatid cyst disease. Axial CT sections show lesions consistent with hydatid cysts in the left lobe of the liver and in the spleen. A suspicious lesion of possible hydatid cyst origin is visible in the upper pole of the left kidney.

Fig. 2

A 42-year-old male patient with splenic hydatid cyst disease. Coronal (A) and sagittal (B) CT sections showing a 13 × 9 cm lesion, consistent with hydatid cyst in the central portion of the spleen.

Fig. 3

A 32-year-old female patient with splenic hydatid cyst disease. An axial CT section shows a hydatid cyst with near complete filling of the spleen.