Does Primary Surgical Management of Liver Hydatid Cyst Influence Recurrence?

Malki, Hadj Omar El; Mejdoubi, Yasser El; Souadka, Amine; Zakri, B.; Mohsine, Raouf; Ifrine, L.; Abouqal, Rédouane; Belkouchi, A.

doi:10.1007/s11605-010-1220-0

Cited by 33 publications

(39 citation statements)

References 28 publications

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“…Compared with radical procedures, conservative procedures have a higher possibility of recurrence, occurring in 10-30% of patients, which remains one of the most signifi cant problems with surgery for hydatid cysts (32) (33) (34) . When recurrent disease occurs, additional surgeries are likely associated with increased rates of operative morbidity and mortality (35) .…”

Section: Discussionmentioning

confidence: 99%

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Abdelraouf

El-Aal

Shoeib

et al. 2015

Rev. Soc. Bras. Med. Trop.

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Introduction: Hydatidosis is the result of infection with the larval stages of some species of the genus Echinococcus. Treatment approaches for hydatid cysts include the use of albendazole, surgery, and/or medico-surgical procedures. The choice of the therapeutic surgical approach depends on the cyst number and localization, surgeon expertise, and presence of complications. The present study aimed to compare the outcomes of the following therapeutic approaches for the treatment of hepatic hydatid cysts: pericystectomy; the puncture, aspiration, injection, and reaspiration (PAIR) technique; and the PAIR technique followed by deroofi ng, evacuation of cysts, and omentoplasty. Methods: The 54 patients were divided into 3 groups: Group I (14 patients) who underwent pericystectomy, Group II (23 patients) who underwent the PAIR technique, and Group III (17 patients) who underwent the PAIR technique followed by deroofi ng and omentoplasty. The diagnosis of hydatid cysts was based on serological testing using enzyme-linked immunosorbent assay, abdominal ultrasound, and parasitological examination of the cyst contents. Morbidity, mortality, length of hospital stay, recurrence, and postoperative complications were evaluated. Results: Postoperative bleeding, infection, and recurrence were reported in Groups I and II; Group III did not experience postoperative infection and had shorter hospital stays. Recurrence and postoperative complications did not occur in Group III. Conclusions: The partial surgical procedure with deroofi ng, evacuation of the cysts, and omentoplasty, as performed in the present study, is recommended as a safe and effective method for elimination of the entire parasite with minimal possibility for intra-peritoneal spillage.

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Section: Discussionmentioning

confidence: 99%

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Abdelraouf

El-Aal

Shoeib

et al. 2015

Rev. Soc. Bras. Med. Trop.

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“…While this group presented data in favour of radical resection, the median follow-up among those undergoing resection was only 1.5 months, thus limiting their conclusions on cyst recurrence. In contrast to these studies, other groups [3][4][5]17,20,21 have documented variable but generally higher recurrence rates with conservative surgical procedures (11%-30%), highlighting the superiority of radical surgery in preventing recurrence of liver hydatosis. It should be noted that at least 1 group did not find any difference in recurrence rates between conservative and radical surgery after 10 years in a large cohort of 672 patients who underwent primarily conservative surgery (80%).…”

Section: Discussionmentioning

confidence: 91%

“…The literature on hydatid liver disease is intensely driven by investigators from Mediterranean centres as a consequence of their extensive experience with this pathology. [3][4][5][6] Over the years, a few contributions from Western centres have appeared, originating mostly in Europe. 7,9,10 In contrast, the North American experience with hydatid disease remains extremely limited owing to the rarity of this pathology and is restricted to rare series and occasional case reports.…”

Section: Discussionmentioning

confidence: 99%

“…Not surprisingly, surgeons in these areas have accumulated extensive experience and reported large series of patients, documenting recurrence rates of 7.7%-30% and morbidity of 21%-80% with conservative surgical therapies. [3][4][5][6] In contrast, liver surgeons working in Western centres -particularly North American hospitals -can be expected to treat only a handful of such patients over the course of their careers. [7][8][9][10][11] In this context, it becomes particularly important to define surgical treatment strategies that are specific to the expertise of Western liver surgeons, which is lacking in the literature.…”

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confidence: 99%

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Surgical management of symptomatic hydatid liver disease: experience from a Western centre

et al. 2014

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Background: Hydatid liver cysts are rare in North America. The objective of this study was to determine the optimal surgical management for hydatid liver cysts treated outside endemic areas. Methods:We reviewed the cases of consecutive patients who underwent management of hydatid liver cysts. Radical liver resections were compared with other types of procedures. Clinical presentation, investigations, perioperative outcomes and longterm follow-up were evaluated. We evaluated disease recurrence using the KaplanMeier method.Results: Forty patients underwent surgery for hydatid liver cysts. Most patients had single (68%) right-sided (46%) cysts with a median size of 10 cm. Most (83%) underwent liver resection with or without drainage/marsupialization. Radical liver resection was carried out in 60% (19 major, 5 minor). Additional procedures were required in 50% (biliary fistulization 30%, diaphragmatic fistulization 20% or paracaval location/ fusion 8%). Postoperative complications occurred in 48%. The median follow-up was 39 months. The 3-year recurrence-free survival was significantly different between patients who had radical resection and those who had other procedures (100% v. 71%, p = 0.002). Conclusion:The surgical management of hydatid liver cysts in North America remains rare and challenging and is frequently associated with fistulizing complications. Excellent long-term outcomes are best achieved using principles of radical liver resection that are familiar to North American surgeons.Contexte : L'hydatidose (kyste hydatique du foie) est une affection rare en Amérique du Nord. Cette étude visait à déterminer quelle était la meilleure façon de prendre en charge cette maladie à l'extérieur de zones où elle est endémique. Méthodes :On a revu les cas de patients consécutifs traités pour des kystes hydatiques du foie. L'ablation radicale du foie a été comparée à d'autres types d'intervention. Le tableau clinique, les examens exploratoires, les résultats périopéra-toires et le suivi de longue durée ont été évalués. On a aussi évalué la récurrence de la maladie en utilisant la méthode Kaplan-Meier.Résultats : Quarante patients avaient été opérés pour des kystes hydatiques du foie. La plupart présentaient des kystes simples (68 %) dans le foie droit (46 %), qui mesuraient en moyenne 10 cm de diamètre. La plupart (83 %) avaient subi une résection hépatique avec ou sans drainage ou marsupialisation. Une résection radicale a été pratiquée chez 60 % des patients (19 cas majeurs, 5 cas mineurs). D'autres interventions se sont avérées nécessaires dans 50 % des cas (fistulisation dans les voies biliaires 30 %, fistulisation dans le diaphragme 20 %, localisation paracave ou fusion 8 %). Des complications postopératoires sont survenues dans 48 % des cas. La durée moyenne du suivi a été de 39 mois. On a observé une différence significative entre le taux de survie sans récidive sur 3 ans entre les patients ayant subi une résection radicale et ceux ayant subi une autre intervention (100 % c. 71 %, p = 0.002). Conclusion :En Amé...

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“…Recurrence is one of the most significant problems in hydatid cyst surgery which occurs in 10 to 30% of patients [32][33][34] and when recurrent disease occurs, further surgery is probably associated with increasing operative morbidity and mortality [35]. Radical procedures have a higher operative risk and a lower risk of recurrence than conservative procedures which have a higher possibility of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Serological Outcomes in Different Surgical Approaches for Hepatic Human Hydatidosis

Abdin¹

2015

J Bacteriol Parasitol

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Does Primary Surgical Management of Liver Hydatid Cyst Influence Recurrence?

Abstract: We think that the surgeon's practice and experience are the most important to success the surgical treatment. It prevents complications and recurrences.

Cited by 33 publications

References 28 publications

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Surgical management of symptomatic hydatid liver disease: experience from a Western centre

Clinical and Serological Outcomes in Different Surgical Approaches for Hepatic Human Hydatidosis

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