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Surgical Procedure Choice for Removing Hepatic Cysts of Echinococcus granulosus in Children
Bo Ran1, Yingmei Shao1, Yusfu Yimiti1
1Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China.
Insights
This study compared radical and conservative surgery for pediatric liver hydatid cysts. Radical surgery showed no recurrences or biliary complications, while conservative surgery was effective but had some complications.
Area of Science:
- Pediatric Surgery
- Hepatobiliary Surgery
- Parasitic Diseases
Background:
- Hepatic cystic echinococcosis (CE) is a parasitic infection requiring surgical intervention in pediatric patients.
- Surgical management of liver hydatid cysts in children involves evaluating different approaches to optimize outcomes.
Purpose of the Study:
- To compare the effectiveness of radical surgery (RS) versus conservative surgery (CS) for treating hepatic cystic echinococcosis in children.
- To analyze postoperative complications, hospital stay, and recurrence rates associated with each surgical method.
Main Methods:
- A retrospective evaluation of 112 pediatric patients with hepatic CE treated between 2002 and 2012.
- Patients were divided into two groups: radical surgery (n=26) and conservative surgery (n=86).
- Data collected included patient demographics, cyst characteristics, surgical procedures, complications, and hospital stay.
Main Results:
- Radical surgery had a significantly longer operative time (126.4 min) compared to conservative surgery (90.4 min).
- Hospitalization duration was similar between groups (approx. 11 days).
- Conservative surgery group experienced bile drainage (7 patients) and cavitary abscess (2 patients); hydrothorax occurred in both groups (5 RS, 1 CS). No recurrences or biliary complications were observed in the RS group.
Conclusions:
- Conservative surgery is an effective approach for liver hydatid cyst removal in pediatric patients.
- Radical surgery is a suitable option for hepatic cysts in lower-risk positions, offering a recurrence-free outcome.
Abstract:
Aim This study aims to evaluate the effectiveness of radical and conservative surgical procedures for removal of hydatid cysts in the liver of children. Methods A total of 112 pediatric patients had surgical treatment of hepatic cystic echinococcosis (CE) between January 2002 and December 2012 at the First Affiliated Hospital of Xinjiang Medical University were retrospectively evaluated. The patients were divided into two groups receiving either radical (n = 26) or conservative surgery (CS) (n = 86). Patient age, gender, symptoms, preoperative radiologic investigations, type of cyst, involvement of other organs, surgical procedure performed, postoperative complications, and mean hospital stay after surgery were recorded. Results The mean surgical procedure time for radical surgery (RS) was significantly longer than CS (126.4 ± 37 vs. 90.4 ± 22.9 minutes, p < 0.001], and the days for hospitalization showed no difference (11.0 ± 2.1 vs. 11.5 ± 3.1 days, p > 0.05]. Seven patients in the CS group had 20-300 mL of bile drainage 2-4 days post-operation and two patients developed a postoperative cavitary abscess; five patients in the RS group and one patient in the CS group developed a hydrothorax on the fifth day postoperatively. Follow-up of all patients showed that the majority had recovered well except for 3 cases who developed recurrences due to cysts ruptured accidently before surgery. There were no recurrences or biliary complications in the RS group. Conclusion CS is an effective method for liver CE cyst removal and RS is suitable for hepatic cysts in less risk position in pediatric patients.
