OUR EXPERIENCE OF THE TREATMENT OF HYDATID CYST OF THE LIVER BY RESECTION OF THE CYST WALL

From January 1976 to December 1990, 495 cases of hydatid cyst of the l iver were treated by resection of the cyst wall. The mean age of the p atients was 42 years with a female predominance (71 % of cases). Confi rmation of the diagnosis was essentially based on ultrasonography. At operation, the hydatid cysts were located in the right lobe of the liv er in 83 % of cases. The hepatic dome (segments VII + VIII) was involv ed in 52 % of cases. After resection of the cyst wall, biliary tract l esions required common bile duct drainage with a Kehr drain in 50 case s, transcystic drainage in 22 cases and cysto-biliary disconnection in 22 cases. In every case, drainage of the residual cyst cavity was per formed by a two-way catheter. Sevent deaths were recorded in this seri es, including one from anaphylactic shock associated with intracystic injection of formalin, 3 from bronchopulmonary complications, 2 from s ubphrenic abscesses and 1 after surgical revision for evisceration on the Sth day. The postoperative morbidity and, consequently, the hospit al stay depended on the condition of the pericystic tissues. The mean hospital stay was 12 days in the case of soft pericystic tissues and 3 2 days in the case of fibrotic and calcified pericystic tissues. Due t o the benig nature of hydatid cysts of the liver, the authors emphasis e the value of resection of the cyst wall which carries a lower operat ive risk and which can be performed by most surgeons.