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Hepatic atrophy-hypertrophy complex due to Echinococcus granulosus

Koray Karabulut1, Ilgin Ozden, Arzu Poyanli

  • 1Department of General Surgery, Hepatopancreatobiliary Surgery Unit, Istanbul University, Istanbul, Turkey.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|March 1, 2006
PubMed

Insights

Hepatic hydatid disease caused by Echinococcus granulosus can lead to the atrophy-hypertrophy complex (AHC). This condition, involving liver atrophy and compensatory hypertrophy, has surgical implications for both cyst removal and bile duct exploration.

Area of Science:

  • Hepatobiliary Surgery
  • Parasitology
  • Radiology

Background:

  • Obstruction of major hepatic or portal veins, or biliary branches, causes the atrophy-hypertrophy complex (AHC).
  • The role of hydatid cysts in causing AHC is debated.
  • Hepatic hydatid disease is caused by Echinococcus granulosus.

Purpose of the Study:

  • To investigate whether hydatid cysts can cause the atrophy-hypertrophy complex (AHC).
  • To confirm AHC in hepatic hydatid disease using volumetric analysis.
  • To highlight surgical implications of AHC in patients with hepatic hydatid disease.

Main Methods:

  • Retrospective analysis of 370 patients undergoing surgery for hepatic hydatid disease.
  • Review of operative notes for recorded AHC.
  • Computed tomography (CT) volumetric analysis of liver hemilivers and cyst volumes in seven patients.

Main Results:

  • AHC was recorded in 16 patients (4.4%) with hepatic hydatid disease.
  • Cysts in the right hemiliver caused right-sided atrophy and left-sided compensatory hypertrophy.
  • Volumetric analysis confirmed AHC, with median cyst volume of 392 ml.

Conclusions:

  • Hepatic hydatid disease can cause the atrophy-hypertrophy complex (AHC).
  • AHC necessitates caution during pericystectomy due to proximity to vital structures.
  • Surgeons must consider hepatoduodenal ligament rotation in AHC patients during common bile duct exploration to prevent vascular injury.

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