The spleen-saving approach is likely an effective method for the removal of CE spleen cysts given that it is a quick procedure and preserves the function of the spleen. Total splenectomy procedures may be performed particularly for larger, centrally located cysts.

Co-infections of cystic echinococcosis (CE) and HIV/AIDS is rare. We report four CE cases that were HIV positive. Three out of the four patients underwent a surgical operation to remove the hydatid cysts in their livers. The operation confirmed that in two of the cases their cysts had ruptured. These patients were given 3 months of albendazole after the operation. Follow-up showed they were remarkably improved in term of their health, although they were still HIV antibody positive 6 months after surgical treatment. Interestingly, the treatment remarkably increased their CD4+ cell population. We showed that surgery is suitable for treating hepatic cystic echinococcosis with HIV/AIDS co-infection.

Aim This study aims to evaluate the effectiveness of radical and conservative surgical procedures for removal of hydatid cysts in the liver of children. Methods A total of 112 pediatric patients had surgical treatment of hepatic cystic echinococcosis (CE) between January 2002 and December 2012 at the First Affiliated Hospital of Xinjiang Medical University were retrospectively evaluated. The patients were divided into two groups receiving either radical (n = 26) or conservative surgery (CS) (n = 86). Patient age, gender, symptoms, preoperative radiologic investigations, type of cyst, involvement of other organs, surgical procedure performed, postoperative complications, and mean hospital stay after surgery were recorded. Results The mean surgical procedure time for radical surgery (RS) was significantly longer than CS (126.4 ± 37 vs. 90.4 ± 22.9 minutes, p < 0.001], and the days for hospitalization showed no difference (11.0 ± 2.1 vs. 11.5 ± 3.1 days, p > 0.05]. Seven patients in the CS group had 20-300 mL of bile drainage 2-4 days post-operation and two patients developed a postoperative cavitary abscess; five patients in the RS group and one patient in the CS group developed a hydrothorax on the fifth day postoperatively. Follow-up of all patients showed that the majority had recovered well except for 3 cases who developed recurrences due to cysts ruptured accidently before surgery. There were no recurrences or biliary complications in the RS group. Conclusion CS is an effective method for liver CE cyst removal and RS is suitable for hepatic cysts in less risk position in pediatric patients.

This study aims to evaluate the clinic value of ultrasound, computed tomography (CT) and serological testing in the differentiation between hepatic Cystic Echinococcosis (CE) types 1 and simple hepatic cysts.Totally 50 patients with CE Types 1 and 50 patients with simple hepatic cysts were included. All patients examined by ultrasound, CT and serological testing respectively. The receiver operating characteristic (ROC) curve of diagnosis methods was drawn and their sensitivity, specificity, Youden index, positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value were compared. Pathology result was used as golden standard.The area under ROC curve of ultrasound was 0.97 and of CT and serological testing was 0.79 and 0.71 respectively. The sensitivity of ultrasound in the diagnosis of CE Types 1 was 96.00%, specificity was 98.00%, the positive likelihood ratio was 48.00, and negative likelihood ratio was 0.04. Disease prevalence was 50%, positive predictive value was 97.96%, and negative predictive value was 96.08%. The sensitivity of CT was 80.00%, specificity was 62.00%, positive likelihood ratio was 2.11, and negative likelihood ratio was 0.32. Disease prevalence was 50%, positive predictive value was 67.80%, and negative predictive value was 75.61%. The sensitivity of immunological test was 86.00%, specificity was 72.00%, positive likelihood ratio was 3.07, and negative likelihood ratio was 0.19. Disease prevalence was 50%, positive predictive value was 75.44%, and negative predictive value was 83.72%. Combined ultrasound and immunological test, the sensitivity and the specificity was 82% and 100% respectively. Combined CT and immunological test, the sensitivity the specificity was 70% and 82% respectively.In the differentiate diagnosis of CE Types 1 and simple hepatic cyst, ultrasound is better than CT with high sensitivity and specificity, therefore recommended. Immunological examination is an important complement to the imaging examination.

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Introduction: Iatrogenic biliary injuries are considered as the most serious complications during cholecystectomy. Treatment may include surveillance, endoscopic, percutaneous interventions or surgery. Better outcomes of such injuries have been shown in cases managed in a specialized unit. We analize clinical picture, diagnosis, treatment and evolution in sixty nine patients attended in the HPB surgery Unit at Hospital General de Mexico in the last eight years. Objective: To evaluate biliary injuries management in a referral biliopancreatic surgery center. Methods: Retrospective, descriptive study. Sixty nine consecutive patients with postcholecystectomy biliary injuries were managed with multidisciplinary team (biliopancreatic surgeon, gastroenterologist, and interventional radiologist) at HPB surgery unit in Hospital General de México, Mexico, DF. Over 8-year period using endoscopy in 3 patients, percutaneous techniques in 11 patients, and surgery in 55 patients. Results: We included 69 patients, 39 with a history of open cholecystectomy and 30 laparoscopic. 55 underwent surgery. Surgery was urgent in 2 patients and elective in 53 patients. All cases where repaired with a Roux-en-Y hepatojejunostomy. There was no mortality after surgery. Conclusions: Management of biliary injuries was much better with multidisciplinary care team with initial minimal invasive technique to major surgery in major complex injury. If the repair can't be done by an experienced hepatobiliary surgeon during the same surgical procedure, proper drainage and timely referral to a specialized centre provides a better outcome.