Related Experiment Video
Updated: Sep 30, 2026
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Surgical management of complicated hydatid cysts of the liver
G D Wagholikar1, S S Sikora, Ashok Kumar
1Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226 014, India.
Insights
Complicated hydatid cysts of the liver, often presenting as infection or intrabiliary rupture, can be successfully managed with surgery. Surgical approach depends on cyst characteristics, ensuring good long-term outcomes for hydatid disease.
Area of Science:
- Hepatobiliary surgery
- Parasitic infections
- Surgical management of liver cysts
Background:
- Hydatid disease, caused by Echinococcus granulosus, frequently affects the liver.
- Complicated hydatid cysts present significant management challenges.
- Early diagnosis and appropriate surgical intervention are crucial for favorable outcomes.
Purpose of the Study:
- To review the clinical presentation of complicated liver hydatid cysts.
- To evaluate the surgical management strategies for these complicated cysts.
- To assess the outcomes of surgical interventions in patients with hydatid disease of the liver.
Main Methods:
- A retrospective review of 43 patients with surgically managed liver hydatid disease between 1991 and 1998.
- Diagnosis was established using ultrasound, CT, and serology.
- Preoperative ERCP was used for suspected intrabiliary rupture.
Main Results:
- Eleven patients (26%) had complicated cysts, most commonly infection (11%) and intrabiliary rupture (9%).
- Infected cysts presented with pain and fever; intrabiliary rupture with jaundice, pain, and fever.
- Surgical procedures included omentoplasty, external, and internal drainage, with no mortality and manageable postoperative morbidity.
Conclusions:
- Hydatid disease is a notable cause of complicated liver cysts, with infection and intrabiliary rupture being common.
- Surgical management of complicated hydatid cysts is effective, with outcomes influenced by cyst characteristics.
- Successful surgical strategies can lead to good long-term results in patients with liver hydatid disease.
Aims:
To review the clinical presentation and surgical management of complicated hydatid cysts of the liver.
Methods:
Forty-three patients with hydatid disease of the liver were managed surgically between 1991 and 1998. There were 14 men and 29 women with a median age of 34 years. An abdominal ultrasound, computed tomography and serology established diagnosis. Preoperative endoscopic retrograde cholangiography was performed in patients with associated jaundice and high suspicion of intrabiliary rupture. Eleven (26%) patients had complicated cysts and formed the basis for our study.
Results:
Infection (n = 5, 11%) and intrabiliary rupture (n = 4, 9%) were the common complications. Intrathoracic rupture and intraperitoneal rupture were encountered in one patient each. All patients with infected cysts presented with pain and fever (n = 5, 100%) while those with intrabiliary rupture had jaundice (n = 4, 100%), pain and fever (n = 3, 75%). Surgical procedures performed in complicated cysts were-infection: omentoplasty (n = 2) and external drainage (n = 3); intrabiliary rupture: omentoplasty (n = 2) and internal drainage (n = 2). Patient with intrathoracic and intraperitoneal rupture underwent external drainage. There was no mortality. Postoperative morbidity was encountered in 14 patients and was more in complicated cysts (n = 6/11; 55%) compared to uncomplicated cysts (n = 8/32; 25%).
Conclusion:
Hydatid disease in not an uncommon problem. Around a fourth of patients, present with complications such as infection or intrabiliary rupture. The site, size, number of cysts and presence of complications govern the choice of surgical procedure. Complicated cysts can be successfully managed surgically with good long-term results.
