Open Surgery for Hepatic Hydatid Disease

Sözüer, Erdoğan; Akyüz, Muhammet; Akbulut, Sami

doi:10.9738/intsurg-d-14-00069.1

Cited by 56 publications

(64 citation statements)

References 30 publications

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“…Cases such as these can also be treated endoscopically by sphincterectomy and replacement of the nasobiliary catheter. Another complication or bile leakage which can be symptomatic or cause the formation of a high output biliary istulae, this can also be managed endoscopically by performing sphincterectomy, nasobiliary drainage, or biliary stenting [7]. Surgical operations except from hepatic resections may leave behind a residual cavity that may easily be mistaken due to imaging techniques for a reoccurrence or any other condition.…”

Section: Complicationmentioning

confidence: 99%

Surgical Management of Hydatid Disease

Vidoura¹,

Parisidou²,

Chatedaki³

et al. 2017

Echinococcosis

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Management of hydatid disease carries a substantial risk of complications and recurrence. The ultimate goal of surgery is to kill the parasites, evacuate the cyst, remove the germinal layer, and obliterate the residual cavity all while preserving the healthy liver tissue. In endemic areas, a conservative approach is preferred. The open surgeries have a substantial risk of complications, such as bile leakage, parasite contamination, and presence of dead spaces, in which an abscess can form. These complications then have to be managed with more radical surgical approaches. The most commonly used surgical approaches are pericystectomy, partial pericystectomy, and even hepatic resection. With the right indications, subadventitial cystectomy has low postoperative complication, mortality, and recurrence. The condition of the cyst and the patient, the general status of the patient and the cyst size, location, and pathology are factors that indicate the optimal surgical approach.

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Section: Complicationmentioning

confidence: 99%

Surgical Management of Hydatid Disease

Vidoura¹,

Parisidou²,

Chatedaki³

et al. 2017

Echinococcosis

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“…The treatment of hydatid cyst is surgical. Desired goals of treatment of liver hydatidosis are complete elimination of parasite and prevention of recurrent disease [2][3][4]. Pericystectomy is presently considered to be ideal operation .…”

mentioning

confidence: 99%

Postoperative fluid collection in a patient with hydatid cyst of the liver

Yıldırım¹,

Zh²,

Yazıcı³

2017

J Transl Sci

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A 55-year-old woman patient was referred to our clinic with the diagnosis of hydatid cyst of the liver. In her CT a lesion measuring 15 cm in diameter was seen in the liver. At laparotomy, we found 15 cm. cystic mass in liver segments III of the left lobe to VI of the right lobe. Cyts was found surrounded by stomach and transverse colon. We performed partial cystectomy and cyst evacuation (Figure 1 and 2). We could not make introflexion because of the non-elasticity of the hepatic parenchyma. We leaved a silastic tube to the cyst cavity. Histological examination showed hydatid membrane with multiple vesicular cysts. The postoperative period was uneventhful. Treatment was started with Albendazole in order to prevent recurrence of hydatid disease. An abdomen CT evaluation at the 6th months showed postoperative changes and fluid collection 15 cm in diameter localized to the cystotomy side (Figure 3). After evaluation and informed consent we performed an ultrasound-guided drainage resulted in collection of about 200 mL of a yellowish aspirate from the cyst location. On the 6th day after the drainage the ultrasound showed a lesion shrinkage to 3 cm. She is free of recurrence or fluid collection 18 months after drainage.Echinococcal hydatid cysts of the liver is frequently seen in endemic regions [1]. The treatment of hydatid cyst is surgical. Desired goals of treatment of liver hydatidosis are complete elimination of parasite and prevention of recurrent disease [2][3][4]. Pericystectomy is presently considered to be ideal operation . As a general rule, prompt emptying of the cyst must be performed to prevent risk of cyst perforation. If the pericyst has been removed and hemorhage or bile leakage excluded, then a omental flab can be used on residual cavity. Once the residual cyst wall has been controlled, introflexion can be performed to prevent a dead space. In spite of this procedures, late follow-up image studies may show fluid collections usually as bilomas and hematomas. Most important problem is to decide either a reccurent cyst or the remnant of previous surgery [5]. The pattern of postoperative symptoms usually includes a sensation of pressure and deep-seated pain at the upper abdominal quadrant. CT is valuable for the diagnosis of recurring patterns. It might be difficult to decide differantial diagnosis of fluid collections. The treatment methods are varied. ConclusionIn cases of manifest collections, ultrasonography-guided emptying of huge collections is useful to relieve the clinic symptoms.With this case we woud like to share our experience with this postoperative follow-up and drainage procedure without residual collections.

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“…When the postoperative bile leakage is drained externally and persists for more than 10 days, this is called biliary fistula. It is the major cause of morbidity and is encountered in 1-25% of the cases [6,8]. In the absence of adequate internal or external drainage, bilioma, biliary abscesses, or biliary peritonitis may develop, which can lead to sepsis resulting in serious morbidity and even mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Pericystectomy (Figure 1) and hepatectomy are examples for radical surgery, which aim a complete excision of the cyst and the pericyst [5]. They have lower complication (0-26%) and recurrence (0-3%) rates than the conservative methods [1,6], but their usage is limited by the anatomic localization and multiplicity of the cysts, since especially in centrally located or bilobular disease, the extent of the surgery exceeds the purpose of the treatment of a benign disease. Also, hepatobiliary surgical expertise and longer operation time are needed for radical surgery, which can be a limitation in endemic regions.…”

Section: Introductionmentioning

confidence: 99%

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Biliary Complications of Hepatic Hydatid Cyst Surgery and Prevention Methods

Konca¹,

Balcı²

2017

Echinococcosis

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Cystic echinococcosis is still one of the main reasons for liver surgery especially in endemic areas. The most common complication of liver hydatid cyst is cystobiliary communication (CBC). Preoperative or intraoperative diagnosis of CBC is essential for the treatment, since it leads to postoperative bile leakage and fistula formation eventually without intervention. Predictive factors such as cyst size, history of jaundice, and degenerated cysts are described for preoperative evaluation. Further preoperative study can be performed for diagnosis in their presence. At the intraoperative phase, every effort should be performed for diagnosis. There are several methods for the investigation of CBC. When a CBC is found, it is also essential to evaluate the biliary system as well. By this way, postoperative complication rates can be lowered. Biliary leakage and fistula formation are the most common postoperative complication of liver hydatid surgery and they are the main reasons of morbidity and mortality. Their rates can be lowered by knowing how to interfere for the treatment. As a result, every effort should be made to detect and prevent these complications during the evaluation and management of cystic echinococcosis.

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Open Surgery for Hepatic Hydatid Disease

Cited by 56 publications

References 30 publications

Surgical Management of Hydatid Disease

Surgical Management of Hydatid Disease

Postoperative fluid collection in a patient with hydatid cyst of the liver

Biliary Complications of Hepatic Hydatid Cyst Surgery and Prevention Methods

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