Forty-four years’ experience (1963–2006) in the management of primarily infected hydatid cyst of the liver

Abstract

Clinical manifestations of an abscess were identified in 75% of the patients. In the earlier cases of the study, the diagnosis was made from the clinical picture, laboratory studies, in combination with plain X-ray, hepatic scintigraphy, and in the later cases with US (ultrasonography), CT (computed tomography) or MRI (magnetic resonance imaging), and ERCP (endoscopic cholangiopangreatography). Abdominal and, rarely, thoracic and abdominal or thoracoabdominal incisions were used. Total cystopericystectomy in 8 patients and partial pericystectomy and proper drainage with one or two drainage tubes of the cystic cavity in the other 69 patients were carried out. Hospital stay was between 13 and 146 days with 5 re-operations. Two patients with grossly suppurated cysts and coexistent medical problems died. The disease recurred in five patients. CONCLUSIONS. We conclude that, under good perioperative antibiotic and metabolic coverage, the infected hydatid cysts have to be completely evacuated and properly drained. The application of "conservative" surgical procedures should be preferred. Further studies are needed to solve the clinical and therapeutic problems of this serious complication.

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

“…However, the mainstay of therapy METHODS currently consists of well-planned surgical techniques and appropriate procedures based on the correct evaluation of disease complications and performed by an experienced team, with adequate postoperative support (14) .…”

Echinococcosis

“…Perioperative albendazole prophylaxis is needed to prevent secondary dissemination and reduces the rate of reactivation after surgery (4.2-6.7 % vs 9.4-23.3 %, with vs without albendazole, respectively) (Arif et al 2008;Gollackner et al 2000). Bile leakage from biliary fistulae and cyst cavity superinfection are the most common complications of surgical interventions (4-14 %) and are managed either conservatively or surgically (Agarwal et al 2005;Canyigit et al 2011;Bedirli et al 2002;Dziri et al 2009;Galati et al 2006;Manterola et al 2003;Prousalidis et al 2008;Caremani et al 2007;Smego and Sebanego 2005). Important cautionary measures are the following: (1) perioperative treatment with albendazole and protection of the surgical field with pads soaked with scolicidal agents to prevent secondary CE and relapses; (2) avoidance of scolecidal agents, in case of open surgery, if cystobronchial or cysto-biliary fistulae are observed (the latter by visualization of the fistula, presence of bile-stained cystic fluid, detection of bilirubin in the fluid, or by cholangiography); and (3) appropriate management of the residual cavity (Junghanss et al 2008).…”

Çocuklarda idrar örneklerinden saptanan toplum kaynaklı gram negatif mikroorganizmaların dağılımı ve 2003-2010 yılları arasında antibiyotik direncindeki artışın değerlendirilmesi

“…Although there is no sufficent number of studies related with preoperative use of benzimidazol derivatives (13), it is generally accepted that preoperative use of these substances for 7-14 days is efficient. In our clinic, benzimidazol derivatives are preoperatively administered for 7-10 days in uncomplicated HC patients.…”