Hydatid disease of the liver: current surgical management

We present our experiences with 44 cases of hydatid disease of the liver. Two-thirds were females, and the average age was 44. The most common symptom was abdominal pain (63.6%), and the most common sign was abdominal mass (48%). Eosinophilia, positive Weinberg and Cassoni tests, ultrasonography and CT scanning were the major tools for diagnosis. There were 67 cysts, 49 (73%) located at the right lobe, 18 (27%) located at the left lobe. Twelve (18%) were complicated. The most common complication was intrabiliary rupture. After evacuation of the cyst, we managed the cyst cavity with one or more of the following procedures: omentoplasty, tube drainage, capitonnage, partial cystectomy, cystectomy and scolicidal agent injection. Infected cases were drained, and choledochotomy and internal or external drainage were performed for intrabiliary ruptured cases. Tube drainage and omentoplasty did not increase mortality. Average hospital stay was 11 days. There was no operative mortality.