Total cystopericystectomy versus traditional cyst evacuation for treatment of hydatid cysts of the liver

ABSTRACT

Echinococcosis is a zoonotic disease that occurs throughout the world. Surgery is the recommended treatment for hepatic hydatid cysts. The purpose of this study is to evaluate the technique of cystopericystectomy for treatment of hydatid cysts of the liver comparing it with the traditional surgical technique of cyst evacuation. Twenty six patients [26] admitted with hydatid disease of the liver in Assiut University Hospital from January 2004 to April 2007. All patients were randomized into two groups, group I [13 patients] were managed by total cystopericystestomy and group II [13 patients] managed by conservative technique of cyst evacuation. History, clinical examination chest X-ray abdominal ultrasonography and computed tomography were performed. All patients were treated with oral albendazole dose for two months after surgery. Blood transfusion hospital stay, post-operative complications, and any evidence of hydatid recurrence were recorded. Surgery was performed on 26 patients with liver hydatid disease [14 men and 12 women] with a mean age of 40.2 years [range 21-73 years]. The mean diameter of the cyst was 6.6cm [range 5-11cm]. Blood transfusion was required in 5 patients in the group of cystopericystectomy and in 2 patients of traditional technique of cyst evacuation. The mean hospital stay was 6.1 days in cystopericystectomy group and 8.2 days in the traditional technique of cyst evacuation. During the follow up period which extended up two years postoperatively, no mortality was verified, the incidence of postoperative complications was 7.6% in the group randomized to cystopericystectomy and it was 23.07% in the group randomized to cyst evacuation. Recurrence of hydatid disease was observed in one patient 7.6% in the group treated by cyst evacuation, but no recurrence was observed in cystopericystectomy group. Surgical treatment of hepatic hydatid disease by total cystopericystectomy combined with medical therapy with albendazole is a valuable alternative to the more conservative technique of cyst evacuation with a lower incidence of morbidity and recurrence