Surgical treatment of hepatic hydatid cysts

The purpose of this study was to evaluate open surgery as a treatment for hydatid liver cysts in our locality.

Between February 1987 and September 1996, 20 patients with hepatic hydatid cysts were surgically treated. The patients were assessed by clinical examination, serologic tests, abdominal ultrasound, and computed tomography.

Right hypochondrial pain was the most common presenting symptom (95%). The most common pathology was a solitary right lobe cyst (40%), and involvement of both the right and left liver lobes occurred in 35% of the patients. Associated visceral (splenic) cysts were diagnosed in 2 patients (10%). Intraoperatively, a cystobiliary fistula was found in 2 patients (10%). An endocystectomy was performed on 12 patients, a pericystectomy on 6 patients, and a segmental hepatic resection on 2 patients. No operative mortality was reported. The mean hospital stay was 10 +/- 5 days. Biliary leakage occurred in 2 patients (10%), a liver abscess occurred in one patient (5%), and right subphrenic collection occurred in 1 patient (5%). Recurrence was detected in 2 patients (10%).

Surgery is still the treatment of choice for hydatid liver cysts. However, advances in pre- and intraoperative imaging techniques, together with pre- and postoperative chemotherapy (benzimidazole compounds) may offer a prospect of reducing or preventing recurrence.