RESULTS OF SURGERY IN HEPATIC EQUINOCOCCO SIS

Echinococcosis of the liver is a disease rarely seen in Switzerland. E . alveolaris is the parasite causing the indigenous cases, while most of the patients infected by E. cysticus have migrated from the Mediter ranean region. 26 patients suffering from echinococcosis of the liver were treated at the Department of Surgery of Zurich University Hospita l between 1983 and 1992. There were 12 female and 14 male patients age d between 21 and 72 years (mean: 41 yrs). In 6 cases the cause was an infection with E. alveolaris (group 1), all the other patients suffere d from E. cysticus infection (group 2). In group 1, there were 3 segme ntectomies, 2 hemihepatectomies and 1 exploratory laparotomy. In group 2, 16 patients underwent pericystectomy. Furthermore, 1 hemihepatecto my, 3 atypical resections and 2 segmentectomies were performed. Compli cations were seen in 100% in group 1 and in in 35% in group 2, respect ively. 2 patients died postoperatively for a mortality of 8%. We concl uded that infections with E. alveolaris are rarely resectable without increasing drastically the risk of the operation. Therefore, postopera tive long-term chemotherapy is necessary. Operations for both types of echinococcosis are fraught with a high rate of complications.