A public health approach to optimizing surgical outcomes for hepatic hydatid cyst: identifying predictive factors for...

Hepatic hydatid cyst (HHC) remains a significant public health challenge in endemic regions, causing substantial morbidity and placing a persistent burden on healthcare systems. While surgery is the primary therapeutic intervention, the high rate of specific postoperative complications, particularly biliary fistulas, necessitates a more strategic approach to clinical risk management and patient stratification to optimize resource utilization. This study aims to identify predictive factors for postoperative complications to guide clinical decision-making and enhance the efficiency of surgical care in endemic settings.

We conducted a retrospective cohort study of 107 patients (168 cysts) who underwent surgery for HHC at the Ibn Al Jazzar University Hospital, Kairouan, over an 8-year period (2017-2025). We analyzed a comprehensive set of clinical, biological, and radiological data using univariate and multivariate binary logistic regression models to isolate independent predictors of specific postoperative morbidity.

Conservative surgical management was employed in 89.7% of patients. The overall postoperative complication rate was 15.9%, with biliary fistula identified as the most frequent specific complication (7.5%). Multivariate analysis confirmed that suspected complications on preoperative CT scans (p = 0.03) and the presence of intraoperative complications (p < 0.01) were independent, significant predictive factors for specific postoperative morbidity.

Preoperative CT imaging is a robust, non-invasive triage tool for identifying high-risk patients, which is critical for health system sustainability. Integrating these predictive markers into clinical protocols will allow for optimized surgical planning, reduced hospital resource consumption, and the mitigation of the public health burden associated with HHC in endemic regions.