Hydatid disease of the liver: a continuing surgical problem.

HYPOTHESIS: To study the results of different surgical strategies in the treatment of liver hydatid disease. DESIGN: A retrospective study of 287 patients. SETTING: A university hospital in Athens, Greece. PATIENTS: Two hundred eighty-seven patients with liver hydatid cysts treated surgically 1977-2004. The cysts were located in the right hepatic lobe in 192 cases, in the left lobe in 66 cases, and in both lobes in 29 cases. Eleven patients had concomitant cysts in other organs and 12 patients had multiple intra-abdominal cysts. RESULTS: All patients were treated surgically. Surgical procedures included external drainage, simple closure, marsupialization, partial cystectomy with omentoplasty, radical procedures, laparoscopic drainage, and radiofrequency ablation. The first 3 techniques carried a higher complication rate (36.5%) compared with the other techniques (17.85%; P<.05). However, omentoplasty and external drainage carried a higher recurrence rate (7.42% overall), as compared with radical procedures (3.22%). CONCLUSION: Omentoplasty and radical procedures carry a lower complication rate compared with the formerly used marsupialization and external drainage. Conservative techniques, such as omentoplasty and/or other procedures, offer an effective control of hepatic hydatidosis and are preferred over radical procedures, when possible.

Liver pathology and cell proliferation after octreotide administration following partial hepatectomy in rats: an experimental study.

Octreotide is a somatostatin analog introduced for clinical use that inhibits the growth of various tumors in rats. This study investigates liver pathology after octreotide treatment following partial (2/3) hepatectomy in rats. Thirty rats, weighing 250-300 g underwent partial hepatectomy and were divided in to two groups. Group A (N = 25) received octreotide subcutaneously [2 microg Sandostatin (Sandoz) in 1 ml normal saline every 12 hr for 15 days]. Group B (N = 5) was injected with 1 ml normal saline subcutaneously every 12 hr for the same time period; animals in this group were used as controls. At the end of the experiment rats were sacrificed and liver tissue was obtained for pathologic examination. Liver sections from group A (octreotide administration) showed extensive cholangiolar and fibrous tissue proliferation in the hepatectomy area, and hypertrophy and swelling of Kupffer cells in the liver parenchyma. Sections from the hepatectomy surface from group B (controls) displayed signs of liver regeneration. Proliferation activity (Ki-67+ cells) was higher in the cholangiolar epithelium in group A and in hepatocytes in group B. In conclusion, the results of this study show that octreotide inhibits liver regeneration, which occurs after partial hepatectomy in rats and enhances hyperplasia of cholangiolar and fibrous tissue.