[Echinococcosis of the liver. Its surgical treatment based on 178 personal cases]

Reported in this paper are 178 patients who had received surgical treatment for echinococciasis of the liver, among them 144 at the Surgical Hospital of Madrid University, between 1962 and 1970, and another 34 at the Surgical Hospital of Granada University, between 1971 and 1982. All of them had been carriers of Echinococcus cysticus. Echinococciasis of the liver usually is not diagnosed until the hydatid cyst begins to cause conspicuous symptoms or complications on account of its own growth. Diagnostic clues are obtainable from laboratory findings (eosinophilia in excess of four per cent), immune reaction, complement fixation reaction according to Weinberg, and intracutaneous test according to Casoni. Diagnosis of the authors' cases had been preceded by scintiscanning. Surgical removal of echinococcus cysts from the liver calls for an undogmatic approach. From among all surgical methods applicable to cyst removal the authors have most frequently used closed marsupialisation, according to Posadas-Dew (65.8 per cent of all cases). Drainage marsupialisation was applied to 25.8 per cent of all cases. The postoperative lethality amounted to 2.3 per cent. Morbidity was low.