Hydatid cyst of the liver [TERAPIA CHIRURGICA DELLA ECHINOCOCCOSI EPATICA]

Between January 1970 and December 1990, 101 patients with hydatid cyst of the liver, underwent 106 surgical procedures. A liver resection was performed in 40 cases and cystopericystectomy in 51 cases (6 patients had a combined procedure) while 10 patients were treated by simple evacuation and drainage. Radical surgery (liver resection and close cystopericystectomy) provided excellent local control of the disease, no recurrences and low morbidity with biliary leakage in 5% and 7.8% respectively and hospital stay between 13 and 16 days. On the contrary, the conservative procedure had a 60.5% complication rate and the mean hospital stay was 25 days. The opening of the cyst either for conservative treatment or partial cystopericystectomy was associated with a high risk of recurrence: 44% and 14% respectively. 4 of the 8 patients with recurrent disease in the liver or abdomen underwent a second radical procedure, while other 4 patients with liver recurrence were given long term therapy with flubendazole. In this second group of patients we observed a reduction in the size of the cyst and disappearance of symptoms. Radical procedure is now the most effective option in the treatment of patients with liver hydatodosis