Complex Hydatid Cysts of the Liver: A Single Center's Evolving Approach to Surgical Treatment

In our study, we arbitrarily define complex hydatid cysts of the liver as either cysts with a diameter > or =10 cm, or as multiple and recurrent cysts. These types of cysts were then divided into two subgroups: giant cyst identified as a cyst with a diameter > or =10 cm, and complicated cyst a...

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Bibliographic Details
Published in:The American surgeon 2010-09, Vol.76 (9), p.1011-1015
Main Authors: BOTRUGNO, Ivan, GRUTTADAURIA, Salvatore, LI PETRI, Sergio, CINTORINO, Davide, SPADA, Marco, DI FRANCESCO, Fabrizio, PAGANO, Dullio, CRINO, Francesca, ANASTASI, Domenico, GRIDELLI, Bruno
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Cysts
Digestive System Surgical Procedures - methods
Diseases caused by cestodes
Echinococcoses
Echinococcosis, Hepatic - diagnostic imaging
Echinococcosis, Hepatic - epidemiology
Echinococcosis, Hepatic - surgery
Female
General aspects
Helminthic diseases
Humans
Infectious diseases
Length of Stay
Male
Medical imaging
Medical procedures
Medical sciences
Middle Aged
Parasitic diseases
Recurrence
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Young Adult
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Summary:In our study, we arbitrarily define complex hydatid cysts of the liver as either cysts with a diameter > or =10 cm, or as multiple and recurrent cysts. These types of cysts were then divided into two subgroups: giant cyst identified as a cyst with a diameter > or =10 cm, and complicated cyst as multiple, recurrent, abscessed cysts, or those resistant to conservative treatment. The aim of this study was to retrospectively analyze a series of 38 consecutive patients who underwent surgery for complex hydatid cysts over a period of 9 years at the same institute to determine the evolution of the surgical treatment and the risk factors for recurrence. Fourteen (36.8%) of these patients were women and 24 (63.2%) men (median age 48.1; range 16-71 years). The mean postoperative followup was 24 +/- 10.8 months. All patients were treated prophylactically with albendazole (10 mg/Kg/day) for 15 days preoperatively and for 2 months postoperatively. Partial cystectomy was performed in two cases (5.26%) and radical pericystectomy in 20 cases (52.63%). In 15 cases the patients underwent liver resection (39.47%): left hepatectomy was performed in eight cases (21.05%), and right hepatectomy in seven cases (18.42%). In one case, both wedge resection and pericystectomy were performed. There were no deaths and only one patient (2.63%) showed signs of recurrence at follow-up. Radical surgery is the most effective treatment for complex hydatid cysts. In our experience, partial or total pericystectomy virtually eliminated, over time, the need for hepatic resection.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481007600939