Evaluation of the necessity of simultaneous cholecystectomy in patients undergoing liver hydatid cyst surgery

Liver hydatid cysts remain a significant public health issue in Turkey, the Middle East, East Asia, and Russia. Surgical treatments are often employed for certain stages of this disease. However, the necessity of simultaneous cholecystectomy during these procedures remains unclear. Treating symptoms related to subsequent cholelithiasis can become more challenging. This study investigates the necessity of simultaneous cholecystectomy by following patients who underwent hydatid cyst surgery with or without concurrent cholecystectomy.

Patients who underwent surgery for hydatid cysts between 2019 and 2024 at the General Surgery Clinic of Ankara Bilkent City Hospital were retrospectively reviewed. A total of 97 patients were included, with 56 (54.32 %) undergoing cholecystectomy along with hydatid cyst surgery (Group 1) and 41 (45.68 %) not undergoing cholecystectomy (Group 2).Preoperative clinical, laboratory, and radiological findings, as well as intraoperative data, morbidity, mortality, and postoperative symptoms, were analyzed.

Patients in Group 1 had longer hospital stays, higher blood loss, and significantly higher Clavien-Dindo complication scores. In the postoperative follow-up of Group 2, 8 patients (19.51 %) developed stones or sludge, and 1 patient (2.4 %) developed polyps. Four patients (9.75 %) presented to the emergency department with cholecystitis symptoms. A total of 5 patients (12.19 %), including 4 with symptomatic cholelithiasis (9.7 %) and 1 with gallbladder polyps (2.4 %), underwent elective cholecystectomy. Two (40 %) of these cholecystectomies were performed laparoscopically, while three (60 %) were converted to open cholecystectomy.

Simultaneous cholecystectomy during liver hydatid cyst surgery may prevent difficulties associated with treating symptoms related to subsequent cholelithiasis.