Clinical experience in treatment of liver hydatid disease

ABSTRACT

To determine the efficiency of using medical therapy [albendazole, mebendazole] in treatment of hydatid liver disease. This study was conducted in Basrah general hospital, Baserah, Iraq during the period of 1989 to 2007. Two hundred and forty eight patients with hydatid liver disease were included in this study, of whom 163 were females and 85 were males. Open surgical treatment was done for 146 patients while 102 patients were treated medically with antihelmintic drugs. Mebendazole [40-50 mg/kg/day] was used for 700 patients, while albendazole [10-15 mg/kg/day] was used in the treatment for 32 patients. The course of medical treatment was continued for 6-12 months. Open surgical treatment were indicated in patients with too large hydatid liver cyst, superficially located hydatid cyst that may rupture spontaneously or traumatically, infected hydatid cyst, hydatid cyst with billiary tree communication, and hydatid liver cyst with pressure effect on vital structures. While medical treatment with albendazole and mebendazole was used for patients with multiple small hydatid cysts, deeply seated hydatid cyst in liver parenchyma, and patients with high risk for anesthesia and major surgical procedure. These antihelmintic drugs devitalize the protoscoleces and germinal layer of hydatid cyst andlower intracystic pressure [[dead cysts]], and so it will decrease the chance of recurrence locally or peritoneally. Out of those medically treated [[102]] patients, 38 patients got complete cure after one year coarse of medical treatment and 42 patients underwent operation for different causes after 3-6 months period. While the remaining 22 patients were lost to follow up. Medical treatment with mebendazoleand albendazole is beneficial in getting complete cure in certain cases. If surgery needed after medical treatment, there will be a decrease in chance of recurrence peritoneally and locally in the liver because of inactivation and devitalization [[death]] of hydatid liver cyst[s]