The management of hepatic hydatid cysts: review of 94 cases.

ABSTRACT

In this retrospective study, 94 patients operated for hepatic hydatid cysts were reviewed to compared the advantages and disadvantages of different operative techniques. The patients were divided into four groups according to the type of operation. Group I consisted of 33 patients with peripherally located small cysts, eligible for excision, who underwent cystectomy. Group II consisted of 28 patients with cysts smaller than 5 cm, not suitable for complete removal, who underwent partial cystectomy with capitonnage. Group III were 21 patients with cysts larger than or equal to 5 cm, not suitable for complete removal, who underwent partial cystectomy with omentoplasty. Infection and biliary communication were not seen in groups II and III. Group IV were 12 patients with infected cyst or intrabiliary rupture who underwent partial cystectomy with external drainage. In group IV, hospital stay was longer than in the other groups (P < 0.05). Group I had the shortest hospital stay (P < 0.05). Group IV had the highest morbidity and recurrence rates (P < 0.05). We concluded that cystectomy is the technique of choice in selected patients, as it is associated with low morbidity, low recurrence rates, and short hospital stay. Omentoplasty is preferred if cystectomy is not feasible. If there is biliary contamination and infection, external drainage, rather than omentoplasty, should be performed.