Open drainage versus overlapping method in the treatment of hepatic hydatid cyst cavities

In order to compare the results of open drainage and overlapping methods, 5 8 consecutive patients with uncomplicated hepatic hydatid disease were inve stigated between January 1990 and January 1997. The cavities were obliterat ed by overlapping method in 26 patients and were left open into the periton eal cavity following partial pericystectomy in 32 patients. Postoperative c omplications and follow-up results of ultrasonography (US) and computed tom ography (CT) were compared between the two groups. In total, there were 56 cysts in the obliterated group and 83 cysts in the open drainage group. The re was no significant difference in age, sex, mean diameter of the cysts, U S features:of the cysts according to the Gharbi classification, and median followup. Mean hospital stay was 10 days in the overlapping group and 7.5 d ays in the open drainage group (P = 0.033). No postoperative complication w as observed in the obliterated group and nearly half of the cyst cavities c ould not be detected in the early postoperative period by US and CT. Pleura l effusion (n = 1) and biliary fistula (n = 1) were detected in the open dr ainage group which disappeared spontaneously. In the open drainage group, U S and CT surveillance revealed that the cyst cavities were reduced in size and the echo pattern was changed in the early postoperative period, whereas the appearance changed into pseudotumor view in the late postoperative per iod. In conclusion, the cyst cavities disappear perfectly in the overlappin g group. Treating the cyst cavity by open drainage is an easy, effective an d safe technique. Open drainage can be a 'method of choice' for patients wi th multiple hydatid cysts and for cysts where management is difficult or un amenable to other methods, but the residual cyst cavities may be misinterpr eted as a new cyst by an inexperienced radiologist.