Surgical treatment of advanced alveolar hydatid disease of the liver: A report of five cases

Abstract

We report herein the cases of five patients with alveolar hydatid disease (AHD) of the liver who were diagnosed and underwent surgery at the Department of Surgery of Ankara University between 1989 and 1994. In all five patients, the final diagnosis was established by frozen section of the lesion during laparotomy. Lesions of AHD were found only in the liver. Hepatic resections including right lobectomy and segmentectomy were performed in three patients while palliative procedures were carried out in the remaining two patients with unresectable disease. There was no operative mortality, and only one late death occurred 3 years after the hepatic resection. In this paper, we present the clinical and operative findings of these five patients and their outcomes, followed by a review of the surgical treatment of AHD.

Palliative operation for the treatment of alveolar echinococcosis

“…However, the rate of palliative surgery decreased over decades (1972-1982, 92%; 1983-1993, 51%; 1994-2004, 19%) [20]. The paper of Bengisun is an example of the rare publications giving the personal experience in palliative resections of a small group of patients because it reports on five patients treated by R2 resection [11].…”

“…None of the papers had the main focus on 'palliative operation for the treatment of AE'. Most publications were retrospective analyses of case series but data were also acquired prospectively to assess the changes in the disease pattern with respect to presenting features, efficacy of biological and morphological examinations, and methods of treatment [2,4,6,[11][12][13][14][15][16][17][18][19].…”

Treatment approach for pulmonary alveolar echinococcosis

“…[7,8] The mean age of diagnosis was reported as 55 years. [8] Although primary location is liver, metastases in other abdominal organs, muscles, bones, lymph nodes, lungs, and brain have been reported.…”

Alveolar Echinococcosis in Turkey

“…Otherwise, the risk of recurrence due to latent microcysts in the surgical margin is increased [7, 17, 18, 19]. Unfortunately, this approach cannot be implemented in a significant majority of the patients as reflected by the wide spectrum of the resectability rates reported in the literature (4–87%) [7, 8, 9, 10, 11, 20, 21]. Because symptomatic patients usually have advanced lesions [22], the key to success is population screening in high-risk areas until public health measures eliminate the endemicity in the region [7, 8, 9, 10, 11].…”