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Open Conservative Surgical Management of Cystic Echinococcosis in a Tertiary Care Hospital, Nepal
Niranjan Kumar Hazra1, Hemant Batajoo1, Samikshya Ghimire2
1Consultant Surgeon, Department of Surgery, Manipal Teaching Hospital , Pokhara, Nepal .
Background:
Cystic echinococcosis (CE) or hydatid disease caused by E. granulosus in Nepal is amenable to surgical treatment.
Aim:
Aim of the study is to evaluate the efficacy of surgical treatment of CE, by open partial pericystectomy with albendazole as adjuvant.
Materials And Methods:
Material of this prospective study were the consecutive series of 33 patients operated for CE, over a period of 8 years, at a single centre. Clinical examination, ultrasonography (USG) and computed tomography (CT) were used for establishing diagnosis. Patients were prescribed perioperative albendazole. Povidone iodine 10% (betadine)was used as contact scolicidal agent during operation. Cysts were evacuated from livers, lungs, retroperitoneum by partial pericystectomy. CE of mesentery was completely excised. Descriptive statistics was obtained using EPI- info windows version soft ware.
Results:
A total of 33 patients were operated for CE; 24 were females and 9 males. Age ranged from 4 years to 80 years. Organs/ site involved were: liver - 24, lungs - 4, combined liver and lungs - 2, retroperitoneum - 2 and mesentery - 1. Complication - bile leak for 2 weeks in an operated CE of liver. There was no mortality. Hospital stay (in days) was - mean 14 (range 7to21). Follow up for 3 years (average 2years) showed no recurrence.
Conclusion:
Evacuation of CE by partial pericystectomy is an effective, safe and simple procedure, and gives excellent cure rate with perioperative albendazole therapy.