[Echinococcus alveolaris and cysticus of the liver]

From 1964-1976 34 patients were treated for Echinococcus of the liver at the Mainz University department of surgery. There were 25 cases of E. cysticus and 9 cases of E. alveolaris. Decisive for the diagnosis are Casoni's intracutaneous test, scout film of the abdomen, liver scan and arteriography. In all cases a surgical therapy is indicated. A central localization of the parasite cysts makes problems to the surgical management. In these cases we prefere the cystectomy. All other echinococcal cysts were removed totally, either by pericystectomy or hepatic lobectomy. Such a radicality is the exception in E. alveolaris. Twice we performed right hepatic lobectomy. In the other cases operative treatment was carried out to confirm diagnosis and ensure bile passage by a hepato-enterostomy. However, palliative bile draining procedures may prolong survival time to more than 10 years.