1. Surgical treatment of hydatid disease of the liver: a 20-year experience
- Author
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Magistrelli, Paolo, Masetti, Riccardo, Coppola, Roberto, Messia, Angelo, Nuzzo, Gennaro, and Picciocchi, Aurelio
- Subjects
Liver ,Parasitic diseases -- Complications ,Echinococcosis -- Care and treatment ,Health - Abstract
Hydatid disease of the liver, endemic to many areas of the Middle and Far East and South America, is seen increasingly in other parts of the world because of emigration. In this condition a hydatid cyst caused by the Echinococcus granulosus organism grows progressively within the liver, causing the liver to enlarge. It may not produce symptoms for a long time. Symptoms are caused by pressure on adjacent organs or by the development of complications such as infection and rupture within the biliary system. Hydatid liver disease is progressive, often recurs and its complications may be life-threatening. Surgery is the main treatment; the best type of surgery, however, remains controversial. A report is presented of 135 consecutive patients with hydatid liver disease, treated surgically over a 20-year period with various techniques. There were 74 women and 61 men in the study group, ranging in age from 4 to 81 years (average 46). The most common complaint was abdominal discomfort or pain (79 percent), liver enlargement (68 percent), dyspepsia (52 percent), fever and chills (30 percent) and jaundice (14 percent). Twenty-seven patients had previously undergone surgery for this condition. Conservative treatment (cyst removal) was carried out on 71 patients. Radical procedures, including partial or total removal of the pericyst (vascular envelope of the cyst) as well as the cyst itself or liver resection, were performed on 64 patients. Operative death rate was 2.2 percent and complication rate was 23.7 percent. Thirteen patients had disease recurrence an average of three years after initial operation. Ten of these patients had previously undergone conservative surgery; three, radical surgery. All recurrences in the conservatively treated patients were in the area of the original cyst; in the radically treated patients recurrence tended to occur in the opposite lobe of the liver. It is concluded that better long- and short-term results were obtained using the radical procedures. (Consumer Summary produced by Reliance Medical Information, Inc.)
- Published
- 1991