Surgical treatment of hydatid disease of the liver: 25 years of experience

Tagliacozzo, S; Miccini, Michelangelo; Bonapasta, Stefano Amore; Gregori, Matteo; Tocchi, A

doi:10.1016/j.amjsurg.2010.02.011

Cited by 56 publications

(65 citation statements)

References 26 publications

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“…The process can also occur outside the cyst, within the pericyst, and this is called exogenous vesiculation. 9 Exogenous vesiculation is likely responsible for the major inflammatory and parasitic complications and postoperative recurrence. 10 Hydatid disease can be asymptomatic, and the diagnosis is often made incidentally.…”

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confidence: 99%

Open Surgery for Hepatic Hydatid Disease

Sözüer

Akyüz

Akbulut

2014

International Surgery

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TurkeyHydatid disease is a zoonosis caused by the larvae of Echinococcus granulosus. Humans are an intermediate host and are usually infected by direct contact with dogs or indirectly by contaminated foods. Hydatid disease mainly involves the liver and lungs. The disease can be asymptomatic. Imaging techniques such as ultrasonography and computed tomography are used for diagnosis. The growth of hydatid cysts can lead to complications. Communication between bile duct and cysts is a common complication. The goal of treatment for hydatid disease is to eliminate the parasite with minimum morbidity and mortality. There are 3 treatment options: surgery, chemotherapy, and interventional procedures. Medical treatment has low cure and high recurrence rates. Percutaneous treatment can be performed in select cases. There are many surgical approaches for managing hydatid cysts, although there is no best surgical technique, and conservative and radical procedures are used. Conservative procedures are usually preferred in endemic areas and are easy to perform but are associated with high morbidity and recurrence rates. In these procedures, the parasite is sterilized using a scolicidal agent, and the cyst is evacuated. Radical procedures include hepatic resections and pericystectomy, which have high intraoperative risk and low recurrence rates. Radical procedures should be performed in hepatobiliary centers. The most common postoperative complications are biliary fistulas and cavityrelated complications. Endoscopic retrograde cholangiopancreatography can be used to diagnose and treat biliary system complications. Endoscopic sphincterotomy, biliary stenting, and nasobiliary tube drainage are effective for treating postoperative biliary fistulas.

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confidence: 99%

Open Surgery for Hepatic Hydatid Disease

Sözüer

Akyüz

Akbulut

2014

International Surgery

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“…Other series of liver surgery for hydatid disease have reported postoperative complication rates of 20%-49%. 3,4,[7][8][9][15][16][17] While the overall complication rate identified in this study (48%) was on the higher end of the previously published range, we argue that this is an acceptable morbidity rate. All recorded complications were classified as Clavien-Dindo grade 3a or less, with 76% of complications classified as grade 1 or 2.…”

Section: Discussionmentioning

confidence: 59%

“…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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“…In literature, recurrences have been observed more frequently in patients undergone conservative procedure compared to the patients undergone radical surgery (24% vs. 3%), and the morbidity was detected to be higher (11% vs. 3%) [37]. Radical surgical procedures are better choices than conservative procedures (level of evidence of 2b and recommendation grade B) [35].…”

Section: Discussionmentioning

confidence: 99%

Uncomplicated Hydatid Cysts of the Liver: Clinical Presentation, Diagnosis and Treatment

Duman¹,

Gırgın²

2016

J Gastrointest Dig Syst

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Hydatid cyst of the liver is zoonosis caused by the larval stages of taeniid cestodes belonging to the genus Echinococcus and is still endemic in the South European regions, Asia, South America, North Africa, Australia, New Zealand and several Asian and European countries. The diagnosis of non complicated hydatid cyst of the liver depends on clinical suspicion. They appear in two ways as general (systemic) symptoms, and local symptoms based on the site and organ on which larva settles. While cysts sometimes recover spontaneously, more severe clinical presentations are observed in immunosuppressive individuals. Ultrasonography is the gold standard diagnostic tool and E. Granulosus antigen 5 (Ag5) and antigen B (Ag B) obtained from cyst fluid are used as a serologic diagnostic method in combination with the imaging method. The current treatment of hydatid cyst of the liver varies from surgical intervention to minimally invasive treatments (percutaneous drainage) or medical therapies. Surgery is still the best treatment tool. Percutaneous drainage and treatment of the cyst is a good option to surgery in selected cases. Multiple, superficial single cysts are the most suitable ones for surgical treatment. Also for complicated infected cysts pressing biliary tree and vital organs, surgery should be the first choice of treatment coming to mind. We believe that the laparoscopic approach should be safe to uncomplicated cysts. The purpose of our article is to provide a current review of clinical, diagnostic, and therapeutic features of hydrated cyst diseases.

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Surgical treatment of hydatid disease of the liver: 25 years of experience

Cited by 56 publications

References 26 publications

Open Surgery for Hepatic Hydatid Disease

Open Surgery for Hepatic Hydatid Disease

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

Uncomplicated Hydatid Cysts of the Liver: Clinical Presentation, Diagnosis and Treatment

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