Minimally invasive spleen-preserving surgery to treat primary splenic hydatidosis: short and long-term outcomes: a cohort study

Abstract

Background: Primary splenic hydatidosis, a rare manifestation of Echinococcus granulosus infection, presents unique diagnostic and therapeutic challenges. This study compares spleen-preserving surgeries with total splenectomy for treating primary splenic hydatid cysts, focusing on short- and long-term outcomes in the Jordanian context, a region particularly affected by this condition.

Methods: This retrospective analysis was conducted on 18 patients diagnosed with primary splenic hydatid cysts at two Jordanian hospitals from January 2015 to June 2021. Selection criteria included confirmed diagnosis and complete medical records. Surgical approaches, including laparoscopic partial splenectomy, cystectomy, and cyst deroofing, supplemented by albendazole therapy, were compared based on patient demographics, symptoms, surgical details, complications, and recurrence rates.

Results: The study group was composed of (n=7, 38.9%) male and (n=11, 61.1%) female patients, with an average age of 33.7 years. Most presented with left upper quadrant pain. Postoperative complications occurred in 22% of patients, with an 11% recurrence rate during follow-up. No significant statistical difference in recurrence rates was observed between spleen-preserving surgeries and total splenectomy. These findings highlight the efficacy of less invasive, spleen-preserving techniques in managing primary splenic hydatidosis, showing comparable outcomes to total splenectomy with minimal impact on recurrence rates.

Conclusion: Spleen-preserving surgery offers a viable alternative to total splenectomy in treating primary splenic hydatid cysts. This approach maintains immune functionality and reduces septic risks, especially in pediatric patients. The study underscores the importance of individualized treatment approaches and suggests further research with larger cohorts for more comprehensive insights into managing this rare condition. The limitations of this study include its small sample size and retrospective nature.

Keywords: echinococcus granulosus; hydatid disease; minimally invasive surgery; primary splenic hydatid cyst; recurrence; spleen-preserving surgery.

Figure 1

Computed tomography scans of a single splenic hydatid cyst. (A) Axial view showing a unilocular cyst (red arrow). (B) Coronal view with the cyst’s position (red arrow). (C) Sagittal view detailing the cyst’s anteroposterior dimension (red arrow).

Figure 2

Computed tomography scans of multiple hydatid cysts in the spleen. (A) Axial view of multiple multilocular hydatid cysts (red arrow). (B) Coronal view showing the cysts’ distribution (red arrow). (C): Sagittal view of the cysts’ vertical spread (red arrow).