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Risk factors for recurrence following surgical treatment of pediatric hepatic hydatid disease
Mohamed Zouari1,2, Manel Belhajmansour3,4, Manar Hbaieb3,4
1Research Laboratory "developmental and induced diseases" (LR19ES12), Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia. mohamed.zouari@medecinesfax.org.
Insights
Postoperative recurrence of hepatic hydatid disease in children is common. High eosinophil counts and long operative times predict recurrence, aiding in risk assessment.
Area of Science:
- Hepatobiliary Surgery
- Pediatric Surgery
- Parasitology
Background:
- Pediatric hepatic hydatid disease poses significant recurrence challenges post-surgery.
- Identifying recurrence predictors is crucial for improving patient outcomes.
Purpose of the Study:
- To identify independent predictors of postoperative recurrence in children treated for hepatic hydatid disease.
Main Methods:
- Retrospective observational cohort study of 115 children treated between 2010 and 2024.
- Recurrence defined as new hydatid cysts post-initial treatment.
- Statistical analysis including univariate and multivariate assessments.
Main Results:
- 18.3% of patients experienced recurrence after a mean of 3.1 years.
- Independent predictors identified: peripheral blood eosinophil count > 1×10⁹/L (OR 11.94) and operative duration > 150 minutes (OR 7.29).
- Preoperative fever, elevated eosinophils, prolonged surgery, and omentoplasty were associated in univariate analysis.
Conclusions:
- Recurrence after pediatric hepatic hydatid surgery is frequent.
- Eosinophilia is a novel, independent predictor of recurrence.
- Biological markers like eosinophil count may aid in perioperative risk stratification and follow-up.
Background:
Postoperative recurrence remains a major challenge following surgical treatment of pediatric hepatic hydatid disease, particularly in endemic regions. The aim of this study was to identify predictors of postoperative recurrence in children undergoing surgery for hepatic hydatid disease.
Methods:
This retrospective observational cohort study included consecutive children who underwent surgical treatment for hepatic hydatid disease between 1 January 2010 and 31 December 2024. Postoperative recurrence was defined as the appearance of new hydatid cysts in the liver or abdominal cavity during follow-up after an initial disease-free period.
Results:
A total of 115 children were included, with a median age of 8 years and a nearly equal sex distribution. Postoperative recurrence occurred in 21 patients (18.3%) after a mean interval of 3.1 ± 1 years. Recurrence was hepatic, intraperitoneal, or combined. In univariate analysis, preoperative fever, elevated eosinophil count, prolonged operative duration, and omentoplasty were associated with recurrence. In multivariate analysis, two factors emerged as independent predictors: peripheral blood eosinophil count > 1 × 10⁹/L (OR 11.94, 95% CI 2.86-49.83; p = 0.001) and operative duration > 150 min (OR 7.29, 95% CI 1.66-31.96; p = 0.008).
Conclusion:
Recurrence after pediatric hepatic hydatid surgery remains frequent. Beyond operative duration, eosinophilia emerges as a novel and independent predictor of recurrence, suggesting a potential role for biological markers in perioperative risk stratification and long-term follow-up.
