SURGICAL-MANAGEMENT OF RUPTURED HYDATID C YSTS OF THE LIVER

During the last 20 years (1972-1992), 421 patients underwent surgery f or hydatid disease of the liver. 96 out of 421 patients had a rupture such as, intrabilliary rupture 49 patients, intrathoracic rupture 43 p atients and free rupture in the peritoneal cavity 4 patients. The surg ical treatment required a variety of procedures: 1) Prolonged tube dra inage of the residual cavity and exploration of the common bile duct f ollowed by either T tube drainage or sphincteroplasty or choledocho-du edonostomy if it was necessary, for intrabiliary rupture. 2) Lung rese ction if it was necessary, and evacuation plus drainage and the hepati c cavity followed by suture of the diaphragmatic rupture of closure of the bronchial opening if present for intrathoracic rupture. 3) Lavage and prolonged tube drainage of the hepatic cavity for free rupture in the peritoneal cavity. Five patients died in the postoperative period one from suppurative cholagitis, one from pulmonary embolism and 3 fr om M.O.F.