Minimally invasive spleen-preserving surgery to treat primary splenic hydatidosis: short and long-term outcomes: a cohort study.

Background: Primary splenic hydatidosis, a rare manifestation of Echinococcus granulosus infection, presents unique diagnostic and therapeutic challenges. This study compares spleen-preserving surgeries with total splenectomy for treating primary splenic hydatid cysts, focusing on short- and long-term outcomes in the Jordanian context, a region particularly affected by this condition. Methods: This retrospective analysis was conducted on 18 patients diagnosed with primary splenic hydatid cysts at two Jordanian hospitals from January 2015 to June 2021. Selection criteria included confirmed diagnosis and complete medical records. Surgical approaches, including laparoscopic partial splenectomy, cystectomy, and cyst deroofing, supplemented by albendazole therapy, were compared based on patient demographics, symptoms, surgical details, complications, and recurrence rates. Results: The study group was composed of (n=7, 38.9%) male and (n=11, 61.1%) female patients, with an average age of 33.7 years. Most presented with left upper quadrant pain. Postoperative complications occurred in 22% of patients, with an 11% recurrence rate during follow-up. No significant statistical difference in recurrence rates was observed between spleen-preserving surgeries and total splenectomy. These findings highlight the efficacy of less invasive, spleen-preserving techniques in managing primary splenic hydatidosis, showing comparable outcomes to total splenectomy with minimal impact on recurrence rates. Conclusion: Spleen-preserving surgery offers a viable alternative to total splenectomy in treating primary splenic hydatid cysts. This approach maintains immune functionality and reduces septic risks, especially in pediatric patients. The study underscores the importance of individualized treatment approaches and suggests further research with larger cohorts for more comprehensive insights into managing this rare condition. The limitations of this study include its small sample size and retrospective nature.

A Case Series of Isolated Primary Hydatid Cyst of the Spleen.

Hydatid disease is endemic mainly in Asia and other sheep-raising areas. In India, hydatid disease has been a very common disease because of its close association with livestock rearing. Hydatid disease is a parasitic infestation caused by Echinococcus granulosus. The usual location of infestation is in the liver sinusoids, lungs, and spleen. Hydatid disease in humans is rare, and a hydatid cyst of the spleen without involving the liver is very rare. The rarity of splenic hydatid disease may pose a diagnostic challenge for clinicians, especially in non-endemic areas. The diagnosis of hydatid disease is based on the epidemiological background of patients, clinical grounds, or noninvasive screening procedures. With this background, we aimed to study the presenting symptomatology and various clinical manifestations of isolated spleen hydatid disease and analyze the morbidity and mortality of hydatid disease. Different surgical modalities and their complications were studied. Three patients operated on for splenic hydatid at our institute were studied retrospectively.

An unusual presentation of primary splenic hydatid cyst.

The larval form of the parasite Echinococcus granulosus causes a hydatid cyst. The most common sites are liver and lungs. We present an unusual case of an isolated primary hydatid cyst of the spleen. In our case, ultrasonography images of the spleen were not suggestive of hydatid disease except a large cystic lesion. We proceeded to conservative splenectomy that detected hydatid cyst incidentally during operation. This issue is considered common in our geographical area. A high suspicion of this disease is justified in endemic regions. Moreover, medical treatment should precede and follow the surgical intervention.