[Results of surgery in hepatic echinococcosis]

Echinococcosis of the liver is a disease rarely seen in Switzerland. E. alveolaris is the parasite causing the indigenous cases, while most of the patients infected by E. cysticus have migrated from the Mediterranean region. 26 patients suffering from echinococcosis of the liver were treated at the Department of Surgery of Zürich University Hospital between 1983 and 1992. There were 12 female and 14 male patients aged between 21 and 72 years (mean: 41 yrs). In 6 cases the cause was an infection with E. alveolaris (group 1), all the other patients suffered from E. cysticus infection (group 2). In group 1, there were 3 segmentectomies, 2 hemihepatectomies and 1 exploratory laparotomy. In group 2, 16 patients underwent pericystectomy. Furthermore, 1 hemihepatectomy, 3 atypical resections and 2 segmentectomies were performed. Complications were seen in 100% in group 1 and in in 35% in group 2, respectively. 2 patients died postoperatively for a mortality of 8%. We concluded that infections with E. alveolaris are rarely resectable without increasing drastically the risk of the operation. Therefore, postoperative long-term chemotherapy is necessary. Operations for both types of echinococcosis are fraught with a high rate of complications.