Hydatid Liver Disease: Long Term Results of a Surgical Management

Salam Daradkeh, Husam El-Muhtaseb, Ghassan Farah, Ahmad S. Sroujieh, Mahmoud Abu-Khalaf

Abstract


Objective: To review the experience of the surgical management of liver hydatid cystic disease between 1973 and 1999.

Patients and Methods: We retrospectively analyzed the files of 169 patients with liver hydatid cyst that were managed surgically between 1973 and 1999 with emphasis on the surgical treatment and its results. There were 112 females and 57 males with a mean age of 39.2±17.9 years (range: 5-85 years).

Results: Most patients were symptomatic, 29.5% presented with abdominal pain, 27% with jaundice or gave a history of jaundice and 6% with weight loss.

Hepatomegaly and palpable abdominal mass were the commonest physical signs. The right liver was affected more than the left 68% and 21.8%, respectively. In 13.6%, the cysts were ≥10 cm in diameter. Pre-operative complications were common in our series (37.8%) and the commonest pre-operative complication was intra-biliary rupture (34%).

The surgical procedures performed were variable, external drainage and omentoplasty were the commonest procedures performed. The mortality, morbidity and recurrence rates were high, 6.5%, 53.8% and 7%, respectively.

Conclusion: The surgical management of liver hydatid disease is still carrying a high morbidity, mortality and recurrence rates, radical surgery when feasible, is associated with better results regarding length of hospital stay, morbidity and mortality than conservative surgery. The best surgical procedure to be employed is yet to be determined. The surgical option should be tailored to the case and according to the surgeon's experience and setup.

Keywords


Hydatid cyst, Intra-Biliary rupture, pre-operative complications

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