Surgical treatment of hydatid disease of the liver - Review of 304 cases

Hypothesis: To review the results of different modalities of treatment of h ydatid disease of the liver. Design: Retrospective study of 304 patients. Setting: A university hospital in Turkey. Patients: Three hundred four patients with hepatic hydatid disease who unde rwent operation between 1981 and 1996. Main Outcome Measures: Mortality and morbidity. Results: Two hundred thirty-eight patients had a cyst on the right lobe, 41 patients had a cyst on the left lobe, and 25 patients had a cyst on both l obes. Forty-five patients had multiple hepatic cysts and 18 patients had co existing cysts in other intra-abdominal organs. Surgical procedures were tu be drainage, capitonnage, omentoplasty, cystectomy, segmentectomy, and cyst oenterostomy. Of the patients with tube drainage, 36 developed an infection of the remaining cavity, 10 developed longlasting biliary fistula, 8 devel oped cholangitis, and 6 developed septicemia. Four patients died of unrelat ed complications. Of the patients with capitonnage, 7 developed cholangitis and 3 developed an infection of the remaining cavity, Of the patients with omentoplasty, 1 developed an infection of the remaining cavity and 1 devel oped cholangitis. One patient who underwent segmentectomy developed pulmona ry complications. Of the patients with cystoenterostomy, 1 developed cholan gitis, 1 developed septicemia, and 1 developed pulmonary complications. Conclusion: For management of; hydatid disease of the liver, capitonnage, o mentoplasty, cyst excision, segmentectomy, or cystoenterostomy are all supe rior to tube drainage.