Diagnosis and treatment of liver hydatid disease

BACKGROUND/AIMS: Human echinococcosis is endemic in some areas of the world , including Mediterranean countries. The liver is the most frequent seat of echinococcosis, involved in about 70% of cases. Because there is still no effective medical therapy, surgery remains the treatment of choice. METHODOLOGY: Twenty-seven patients operated on for liver hydatid disease be tween 1990 and 1995 were analyzed and compared with results obtained from a study undertaken at our clinic between 1960 and 1988. RESULTS: The diagnosis was established by typical case history, clinical fe atures and laboratory tests, of which imaging methods proved most informati ve. Radical procedures (total pericystectomy and liver resection) seem to b e too aggressive for treatment. Marsupialization and drainage were mostly a bandoned, because of high morbidity rates. CONCLUSIONS: Among surgical procedures used at our clinic, evacuation of th e cyst with partial excision of the pericyst and omentoplasty resulted in t he lowest morbidity and, thereupon, the shortest postoperative hospital sta y and the best clinical results.