Surgical management of hydatid disease of the liver

The authors review 143 consecutive, surgically treated cases of hydatid disease of the liver seen over the past 10 years. Of the 208 cysts found, 82 (39.4%) were complicated; the remainder were simple. The complications included rupture into the biliary system (16.3%), suppuration (11.0%), partial calcification of the pericyst (5.8%), intraperitoneal rupture (4.8%), bronchobiliary fistula (0.9%) and cystocutaneous fistula (0.5%). External capitonnage was the most commonly used surgical technique (63.0%), followed by cystectomy (17.8%), omentoplasty (10.6%), tube drainage (7.7%) and cystojejunostomy (0.9%). Capitonnage was carried out with or without tube drainage. The complications of surgery were higher with drainage than without. The main complications of surgery were infection in the residual cavity and biliary fistula. The patients who underwent external capitonnage without drainage or omentoplasty had good results with minimal complication rates (3.5% and 4.5% respectively). For the patients in whom the cystectomy was established, the complication rate was 8.1%.