Selecting a surgical modality to treat a splenic hydatid cyst: total splenectomy or spleen-saving surgery?

We analyzed the outcomes and effectiveness of surgical treatments and clinical manifestations of splenic hydatid cysts.

Between 2000 and 2011, we retrospectively reviewed the cases of 11 patients who were operated on for a splenic hydatid cyst. The demographic features, medical history, physical examinations, biochemical and serological tests, imaging modalities, and surgical treatment of the patients were noted.

The mean patient age was 36.45 years (range, 20-66 years). While isolated splenic hydatid disease was present in five patients, other abdominal hydatid cysts were accompanied by a splenic hydatid cyst in six patients. Left upper abdominal pain was present in seven (64%) patients, whereas four (36%) patients were asymptomatic. Eight patients (72.72%) had undergone a total splenectomy and three (27.28%) had undergone spleen-preserving surgery. Postoperative complications developed in four (36%) patients at 5-15 days postoperatively.

Management of a splenic hydatid cyst is not consensual. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in selected patients. The choice of technique depends on the localization, number, and size of hydatid cysts, and the absence or presence of other hydatic organ cysts.