Surgical treatment of hydatid disease of the liver -: Review of 304 cases

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 longlasting biliary fistula, 8 developed cholangitis, and 6 developed septicemia. Four patients died of unrelated 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.