Surgical treatment of hepatic hydatid cysts

Abstract

Background/aims: The purpose of this study was to evaluate open surgery as a treatment for hydatid liver cysts in our locality.

Methodology: Between February 1987 and September 1996, 20 patients with hepatic hydatid cysts were surgically treated. The patients were assessed by clinical examination, serologic tests, abdominal ultrasound, and computed tomography.

Results: Right hypochondrial pain was the most common presenting symptom (95%). The most common pathology was a solitary right lobe cyst (40%), and involvement of both the right and left liver lobes occurred in 35% of the patients. Associated visceral (splenic) cysts were diagnosed in 2 patients (10%). Intraoperatively, a cystobiliary fistula was found in 2 patients (10%). An endocystectomy was performed on 12 patients, a pericystectomy on 6 patients, and a segmental hepatic resection on 2 patients. No operative mortality was reported. The mean hospital stay was 10 +/- 5 days. Biliary leakage occurred in 2 patients (10%), a liver abscess occurred in one patient (5%), and right subphrenic collection occurred in 1 patient (5%). Recurrence was detected in 2 patients (10%).

Conclusions: Surgery is still the treatment of choice for hydatid liver cysts. However, advances in pre- and intraoperative imaging techniques, together with pre- and postoperative chemotherapy (benzimidazole compounds) may offer a prospect of reducing or preventing recurrence.