Retrospective Review of Complications of Liver Hydatid Cyst Surgery with Emphasis on Outcomes of Omentoplasty
Background: The outcome and complications of liver hydatid cyst surgeries with new and old techniques are not well determined. We intended to present the results of operations done for patients with hepatic hydatid cyst in an endemic area.
Methods: Data of 112 patients referred and operated for liver hydatid cyst, in Imam Khomeini Hospital complex, Tehran, Iran, from 2015 to 2018, were collected including demographic characteristics, operation parameters and complication related statistics. The variables were presented for different surgical methods including operations with and without omentoplasty.
Results: Patients aged 39. 3 ± 13. 9 yr (70 females; 63. 5%). Most frequent clinical complaint was vague abdominal pain (n=45; 40. 2%). The most prevalent comorbidity was hypertension (18; 16.0%). Conservative methods were chosen more frequently including omentoplasty (44; 39. 3%), cyst drainage (27; 24. 1%), cyst resection (19; 17%) and marsupialization (3; 2. 7%). Overall, 56 patients (50%) were operated with omentoplasty as the single method or in combination with segmentectomy. Complications occurred less in patients operated with omentoplasty (41. 1 vs. 23. 2%; P=0. 043); particularly, biloma was more frequent in surgeries without omentoplasty (7. 1 vs 0. 0%; P=0. 042). Persistence and recurrence rates were 12. 5% and 3. 6% with relative predilection in, respectively, segmentectomy and lobectomy surgical methods compared to Omentoplasty. No mortality was recorded.
Conclusion: In our case series of hepatic hydatid cyst patients, omentoplasty was safe with less complication and similar long-term recurrence rate.
2. Eckert J, Gemmell MA, Meslin FX, et al. World Health Organization. WHO/OIE manual on echi-nococcosis in humans and animals: a public health problem of global concern. 2001.
3. Buttenschoen K, Buttenschoen DC. Echinococcus granulosus infection: the challenge of surgical treatment. Langenbecks Arch Surg. 2003;388(4):218-30.
4. Sielaff TD, Taylor B, Langer B. Recurrence of hydatid disease. World J Surg. 2001;25(1):83-6.
5. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveo-lar echinococcosis in humans. Acta Trop. 2010;114(1):1-16.
6. Pandey A, Chandra A, Masood S. Abdominal echi-nococcosis: outcomes of conservative surgery. Trans R Soc Trop Med Hyg. 2014;108(5):264-8.
7. Grosso G, Gruttadauria S, Biondi A, et al. World-wide epidemiology of liver hydatidosis including the Mediterranean area. World J Gastroenterol. 2012;18(13):1425-37.
8. Deplazes P, Rinaldi L, Rojas CA, et al. Global Dis-tribution of Alveolar and Cystic Echinococcosis. Adv Parasitol. 2017; 95:315-493.
9. Schantz PM. Epidemiology and control of hydatid disease. Echinococcus and hydatid disease. 1995:233-331.
10. iGavara CG, López-Andújar R, Ibáñez TB, et al. Review of the treatment of liver hydatid cysts. World J Gastroenterol. 2015;21(1):124-31.
11. Stojkovic M, Weber TF, Junghanss T. Clinical man-agement of cystic echinococcosis: state of the art and perspectives. Curr Opin Infect Dis. 2018;31(5):383-92.
12. Georgiou GK, Lianos GD, Lazaros A, et al. Surgi-cal management of hydatid liver disease. Int J Surg. 2015;20:118-22.
13. Tagliacozzo S, Miccini M, Bonapasta SA, et al. Sur-gical treatment of hydatid disease of the liver: 25 years of experience. Am J Surg. 2011;201(6):797-804.
14. ÇOKER A, Aydin U,Yazici P, et al . The optimal treatment of hydatid cyst of the liver: radical surgery with a significant reduced risk of recurrence. Turk J Gastroenterol. 2008;19(1):33-9.
15. Yüksel O, Akyürek N, Şahin T, et al. Efficacy of radical surgery in preventing early local recurrence and cavity-related complications in hydatid liver dis-ease. J Gastrointest Surg. 2008;12(3):483-9.
16. Atmatzidis KS, Pavlidis TE, Papaziogas BT, et al. Recurrence and long-term outcome after open cys-tectomy with omentoplasty for hepatic hydatid dis-ease in an endemic area. Acta Chir Belg. 2005;105(2):198-202.
17. Keong B, Wilkie B, Sutherland T, et al. Hepatic cystic echinococcosis in Australia: an update on di-agnosis and management. ANZ J Surg. 2018;88(1-2):26-31.
18. Malik AA, Bari SU, Amin R, et al. Surgical man-agement of complicated hydatid cysts of the liver. World J Gastrointest Surg. 2010;2(3):78-84.
19. Dziri C, Haouet K, Fingerhut A. Treatment of hydatid cyst of the liver: where is the evidence?. World J Surg. 2004;28(8):731-6.
20. Gloor B, Ly Q, Candinas D. Role of laparoscopy in hepatic cyst surgery. Dig Surg. 2002;19(6):494-9.
21. Kern P, da Silva AM, Akhan O, et al. The echino-coccoses: diagnosis, clinical management and bur-den of disease. Adv Parasitol.2017;96:259-369.
22. Dziri C, Paquet JC, Hay JM, et al. Omentoplasty in the prevention of deep abdominal complications af-ter surgery for hydatid disease of the liver: a multi-center, prospective, randomized trial. J Am Coll Surg. 1999;188(3):281-9.
23. Köksal N, Müftüoglu T, Günerhan Y, et al. Man-agement of intrabiliary ruptured hydatid disease of the liver. Hepatogastroenterology. 2001;48(40):1094-6.
24. Mentes A, Yüzer Y, Ozbal O, et al. Omentoplasty versus introflexion for hydatid liver cysts. J R Coll Surg Edinb. 1993;38(2):82-5.
25. Balik AA, Başoğlu M, Çelebi F, et al. Surgical treat-ment of hydatid disease of the liver: review of 304 cases. Arch Surg. 1999;134(2):166-9.
26. Manterola C, Roa JC, Urrutia S, et al. Treatment of the residual cavity during hepatic hydatidosis sur-gery: a cohort study of capitonnage vs. omentoplas-ty. Surg today. 2013;43(12):1412-8.
27. Muftuoglu MT, Koksal N, Topaloglu U. The role of omentoplasty in the surgical management of remnant cavity in hepatic hydatid cyst. HPB (Ox-ford). 2005;7(3):231-4.
28. Tuxun T, Zhang JH, Zhao JM, et al. World review of laparoscopic treatment of liver cystic echinococ-cosis—914 patients. Int J Infect Dis. 2014;24:43-50.
29. Jerraya H, Khalfallah M, Osman SB, et al. Predic-tive factors of recurrence after surgical treatment for liver hydatid cyst. Surg Endosc. 2015;29(1):86-93.
|Issue||Vol 15 No 4 (2020)|
|Liver hydatid cyst Post-operation compli-cations Conservative surgery Omentoplasty|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|