Objectives: We retrospectively examined our clinical data on hydatic c
ysts of the liver collected over the last 10 years in order to determi
ne a classification which could be used to guide future therapeutic de
cisions. Methods: From 1982 to 1992, hydatic cysts of the liver were s
urgically removed in 378 patients (mean age 38 +/- 12 years). Echograp
hy had been performed in all patients. Other preoperative investigatio
ns included computerized tomodensitometry (n = 57) and arteriography o
f the caeliomesenteric arteries (n = 12). Histological examination of
surgical specimens included research for parasite inclusions within th
e pericyst and the hepatic parenchyma. Results: Single cysts were foun
d in 65.7% of the cases, double cysts in 20% and multiple cysts in 12.
5%. Histology revealed parasites in the pericyst in 129 cases (34%) an
d a fistula from the cyst to the bile duct was observed in 47 cases (1
2.5 %). A classification was obtained based on 5 criteria: localizatio
n and number of cysts, cyst content, morphology of the pericyst and bi
liary-cyst fistula. Conclusion: The excellent correlation between this
classification and prognosis provides a valuable tool for the managem
ent of hepatic hydatic cysts.