Liver dome hydatid cyst surgery: Laparotomy or thoracotomy?

Area of Science:

• Hepatology
• Surgical Gastroenterology
• Parasitology

Background:

• The liver is the most frequently affected organ by hydatid cysts, with a 75% incidence rate.
• While all liver lobes can be involved, the right lobe shows higher susceptibility.
• Specific involvement patterns of the liver dome and segments 7 and 8 have not been extensively documented.

Purpose of the Study:

• To analyze surgical outcomes for liver hydatid cysts.
• To investigate the efficacy of different surgical approaches (laparotomy vs. thoracotomy) for liver hydatid cysts.
• To report on the involvement of the liver dome and segments 7 and 8 in hydatid cyst disease.

Main Methods:

• A retrospective analysis of 240 patients who underwent surgery for liver hydatid cysts between 2005 and 2017.
• Evaluation of variables including patient demographics, cyst characteristics, lobe/segment involvement, and surgical approach.
• Comparison of outcomes between patients undergoing laparotomy and thoracotomy.

Main Results:

• The majority of patients were male, with ages ranging from 8 to 68 years.
• Right lobe involvement was most common; 62 patients had cysts in the liver dome and segments 7 and 8, necessitating thoracotomy.
• No significant difference in analgesic use was found between laparotomy and thoracotomy groups, with a pain score of 4-5 on the VAS scale.

Conclusions:

• Surgery remains the primary treatment for liver hydatid cysts.
• Thoracotomy is a viable surgical option for cysts involving the liver dome and segments 7 and 8.
• A novel method combined with computed tomography (CT) scan is proposed to enhance surgical success and minimize complications like cyst rupture.