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Hepatic hydatid disease: surgical experience over 15 years
Rauf M Agayev1, Beyukkishi A Agayev
1Department of Surgical Diseases, Azerbaijan Medical University, Baku, Azerbaijan.
Background/Aims:
This study aimed to review the authors' surgical experience in hepatic hydatid disease over a 15-year period.
Methodology:
The results of surgical treatment of 484 patients (37.2% male; 62.8% female) aged 5-82 years, with liver echinococcosis (LE), were analyzed.
Results:
Complications of the disease were evident in 226 (47%) patients. These were: cyst calcination, 34 (7%); bile ducts rupture, 128 (26.4%); cyst suppuration, 120 (24.8%); and abdominal cavity perforation, 6 (1.2%). In the diagnostics of liver echinococcosis and its complications, the most informative techniques were ultrasonography and CT. Surgical treatment included: echinococcectomy with complete liquidation of residual cavity (22.1%); echinococcectomy with suturing and external drainage of residual cavity (57.8%); external drainage of residual cavity (11.4%); pericystectomy (6.6%); and liver resection (2.1%). Postoperative complications developed in 118 (24.3%) patients; of these, specific complications occurred in 74 (15.3%) patients. Eight (1.6%) patients had lethal outcomes. The development of purulent biliary complications was connected with peculiarities of parasitic cysts, the character of preoperative complications of the hydatid cysts, and the type of operative intervention: in patients, who underwent echinococcectomy with complete liquidation of residual cavity these complications developed in 4% of cases, whereas the occurrence in patients who underwent operations with external drainage of residual cavity, was 15.2% (P < 0.01).
Conclusions:
Laser irradiation is an essential aid in the prevention of specific complications: application during operation for processing a residual cavity and in the postoperative stage (transcutaneous irradiation of a zone of residual cavity projection or direct irradiation through a drainage tube) is effective. The laser processing of a residual cavity accelerates healing of the residual cavity by approximately 1/3 of the time, and reduces the number of purulent complications by almost 2.5, thereby reducing the patient's number of hospital stay days.
