Surgical Treatment of Hepatic Hydatid Cysts

Abstract

This is a retrospective study of 44 surgical cases of hepatic hydatid cysts. The most common procedure was omentoplasty in 26 patients (55.3%), 10 with omentoplasty alone and 16 combined with partial cystectomy and tube drainage. The second most common procedure was external tube drainage in 15 (32.0%), where complication rates were higher (73.3%) than omentoplasty (15.4%). The most controversial aspect of hydatid surgery is the management of the cyst cavity. The major advantage of omentoplasty is that it is easy to perform and it is the best way to obliterate the remaining cavity. Hospitalization was shortest for omentoplasty. There was no mortality.

Hydatid Liver Disease: A Perspective in Treatment

“…The common causes for surgical morbidity are listed in table 2. The overall morbidity rate at our insti [28], but it is not significantly different be tween resective methods and cavity manage ment techniques [29]. The two main reasons for postoperative biliary fistulization are un detected biliary communications and unsuc cessful repair of bile leaks.…”

“…Transient biliary fistula in our unpublished experience is 2.6%. This low rate compared to figures such as 14% [29], 10.6% [31], and 20% [28] may be due to a more thorough research, as well as to employing silk or polyglycolic acid sutures for the repair of the biliary communi cation instead of chromic catgut as practiced by others. Untreated biliary communications may lead to postoperative biliary fistulas or obstructive jaundice during follow-up, neces sitating endoscopic sphincterotomy [40][41][42], with or without endoscopic extraction of hy datid debris.…”

“…This group of surgical procedures can be referred to as cavity management techniques. Table 1 presents an analysis of 1,863 pa tients compiled from 16 series published in the English literature [10,11,23,25,[27][28][29][30][31][32][33][34][35][36][37][38] between 1978 and 1992. Reported mortality rates vary from 0% in relatively small series [11,25,28,29,34] to between 1.0 and 6.3%.…”

“…Most authors reported a mortality rate less than 3%. Belli [11,26] reported no mortality in a series of 42 patients who received resec tive surgery in 74% of the instances, while others [10, 28,29,31] reported equal results with series in which resective methods were employed much less and the majority of the patients were treated by either conservative methods or cavity management techniques. We reported 0% mortality in a series of 43 patients treated by omentoplasty or introflection [20].…”

Operative Therapie des Echinococcus granulosus (cysticus)

“…Die Obliteration der Cyste ist meist aufgrund der fibrösen Adventitia erschwert [15,24,25,34,38,41]. Man beginnt am tiefesten Punkt der Cyste und bringt die Ränder der Cyste mit Matrazennähten zusammen.…”