This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (10)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Surgery, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Cuneyt Kayaalp, MD; Neriman Sengul, MD; Musa Akoglu, MD

Arch Surg. 2002;137:159-163.

Hypothesis  Cyst content in hydatid liver surgery is a determinant of postoperative cavity-related complications.

Design  Cohort analytic study.

Setting  Referral public hospital.

Patients  Sixty-seven patients who had conservative surgery for hydatid liver disease were analyzed prospectively. Cysts were grouped as to the contents. Cysts containing bile and/or pus were considered complicated, whereas others were uncomplicated. After partial cystectomy, cavities were managed with external drainage, omentopexy, or introflexion, determined by the choice of the surgeons.

Main Outcome Measures  Outcomes were measured by postoperative cavity-related complications, such as biliary leakage (leakage for 10 days or less), biliary fistula (leakage for more than 10 days), cavity infections, and postoperative hospitalization.

Results  Patient and cyst characteristics were comparable among the groups. External drainage technique had slightly more frequent cavity-related complications than omentopexy or introflexion (1.5-fold to 2-fold difference). More importantly, complications were significantly more frequent in the complicated cysts than in the uncomplicated cysts (7-fold to 30-fold difference). Mean postoperative hospitalization time for uncomplicated cysts was 6.5 days, and it was similar whether they were treated by external drainage, omentopexy, or introflexion (7.0, 6.2, and 5.8 days, respectively). Mean postoperative hospitalization time for complicated cysts was longer than for uncomplicated cysts (17.5 days; P = .008).

Conclusions  Uncomplicated cysts have lower complication rates and short hospital stay with each cavity management technique. Complicated cysts have higher complication rates and longer hospital stay regardless of the management technique. Therefore, complicated and uncomplicated cysts should be considered different forms of the disease and evaluated differently.

From the Department of Gastrointestinal Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?