[The therapeutic options in central hydatid cysts of the right hepatic lobe]

The authors of the article propose a method that is highly efficient and presents minimal risks in the treatment of hepatic hydatid cysts located in the central area of the right lobe. This "dangerous area" of the VIIIth segment generates the most delicate problems for the surgical treatment, due to limitation of therapeutic solutions and the highest rate of postoperative complications. The technique presented is that of external extraperitoneal transligamentous drainage introduced by D. Burlui in 1968. This technique should be considered as an alternative to lobectomies or wedge resections or to the direct external drainage of the remaining cavity, the latter being responsible for numerous complications. Considering the figures covering the past 35 years at Caritas Hospital, the authors note the decrease of corrective reinterventions from 27% to 10% after 1968. By associating cholecystectomy after 1983 they dropped to only 4%. The authors do not claim that the method should be universally applied but consider it obviously the choice in the treatment of hydatid cysts in the "dangerous area" in which other therapeutic methods are inappropriate (pericysto-digestive anastomosis) or excessive (right lobe resection), avoiding the problems of direct drainage.