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Review of 304 Cases

Ahmet A. Balik, MD; Mahmut Baolu, MD; Fehmi Çelebi, MD; Durkaya Ören, MD; K. Yalçin Polat, MD; S. Selçuk Atamanalp, MD; Müfide N. Akçay, MD

Arch Surg. 1999;134:166-169.

Hypothesis  To review the results of different modalities of treatment of hydatid 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 underwent 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 lobes. Forty-five patients had multiple hepatic cysts and 18 patients had coexisting cysts in other intra-abdominal organs. Surgical procedures were tube drainage, capitonnage, omentoplasty, cystectomy, segmentectomy, and cystoenterostomy. Of the patients with tube drainage, 36 developed an infection of the remaining cavity, 10 developed long-lasting biliary fistula, 8 developed cholangitis, and 6 developed septicemia. Four patients died of unreleated 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 developed cholangitis. One patient who underwent segmentectomy developed pulmonary complications. Of the patients with cystoenterostomy, 1 developed cholangitis, 1 developed septicemia, and 1 developed pulmonary complications.

Conclusion  For management of hydatid disease of the liver, capitonnage, omentoplasty, cyst excision, segmentectomy, or cystoenterostomy are all superior to tube drainage.

From the Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.

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