The Surgical Management of Hydatid Cyst of the Liver: What is New?

Abstract

Liver hydatid cyst is a disease of zoonosis caused by Echinococcus granulosus or less frequently by Echinococcus multilocularis and Echinococcus oligarthrus. The primary carriers are canines, while human beings are secondary hosts. Early diagnosis is important for cysts not to become complicated and for the treatment not to get difficult. The most effective treatment of uncomplicated hydatid cyst is to reduce the dead space of the cavity and to discharge the fluid as much as possible. However, if the cysts get complex, there is no standard treatment management defined other than offered management options by authors. In complex conditions, the treatment is determined according to the stage of the cyst and the relation of the cyst with biliary ducts or surrounding organs. In this chapter, the treatment regimens of liver hydatid disease mainly based on interventions and surgical operations are going to take a part.

Liver cystic echinococcosis: a parasitic review

“…It is associated with a higher risk of recurrence (20-25%) compared with radical surgery (0.6-4%). 23 The increased risk may be due to intra-abdominal spillage during cyst-content evacuation and incomplete removal of the cyst's entire residual germinal layer. Another less common mechanism journals.sagepub.com/home/tai TherapeuTic advances in infectious disease whereby cyst recurrence may occur is through exogenous vesiculation.…”

“…4,13,22 IHA testing has a sensitivity of 90%; however, if the result is positive, it may remain positive for several years after that. 23 Routine blood tests may show non-specific changes. Only about 40% of patients have abnormal liver function tests.…”

“…Once the cystic cavity is evacuated of its contents, the cavity needs to be obliterated either with capitonnage or omentoplasty. 4,23,25 Although this conservative technique is deemed a safer peri-operative approach than radical surgery, it is not without complications. It is associated with a higher risk of recurrence (20-25%) compared with radical surgery (0.6-4%).…”

“…Partial cystectomy is also associated with an increased risk of post-operative cystic complications, including biliary fistula and cystic cavity infection. 9,23 Most Source: Surgical Approaches Adapted from Kern et al 20 post-operative biliary fistulas may be managed conservatively with percutaneous tube drainage. However, ERCP and biliary stent placement for biliary drainage are indicated for a post-operative biliary fistula with ongoing duration (> 10 days) or for a continuous, large output fistula.…”

“…However, ERCP and biliary stent placement for biliary drainage are indicated for a post-operative biliary fistula with ongoing duration (> 10 days) or for a continuous, large output fistula. 4,9,19,23 Laparoscopic or robotic surgery has revolutionised surgical techniques in most fields. The most notable advantages are shorter hospital stays, reduced wound complications and less post-operative pain.…”