TREATMENT OF HEPATIC HYDATID CYST
Hydatid cysts of the liver are benign lesions which require a wide range of surgical strategies for their treatment. The complex treatment of the hepatic echinococcosis has made great progress to less invasive therapy for this category of patients. The multimodal therapy is represented by administration of antiparasitic agents, interventional radiology, interventional endoscopy, eco- or CT-guided puncture, laparoscopy and associations between those. There are still difficulties in the treatment of complex echinococcosis, especially of the cases with one or more complications. Material and methods: We analyzed retrospectively a group of 74 patients who underwent surgery for complex hydatid cysts over several years at General Second Surgical Clinic, Iasi, Romania, between 2005-2021, in order to determine the evolution of the surgical treatment. We recorded the following parameters: age, gender, place of origin, serological and paraclinical investigations relevant to liver function and Echinococcus granulosus infection, affected hepatic segment, surgical technique, postoperative evolution and days of hospitalization, complications, recurrences and chemotherapy. Results: From the total number of patients admitted in our clinic diagnosed with hepatic hydatid cyst, only 30.7 % had surgical indication. We performed the surgical treatment of the hydatid cyst by laparoscopic approach in 35.1% of cases and a classic approach 56.8%. The surgical technique used in the most cases was partial peri cystectomy (n=54, 73%), total cysto-peri cystectomy in 8.1 % of cases (n=6), and simple drainage of the remaining cavity after the inactivation of the parasite, in the rest of the cases (n=14, 18.9%). The post-operative biliary fistula was encountered in 19 cases (28.4%), with no significant correlation between the surgical approach and the apparition of biliary fistula, the percentage being similar in laparotomy and laparoscopy, with only a 3% difference towards the laparotomy. Conclusions: The biliary fistula remains rather frequent complication of the hepatic hydatic cyst and it’s a challenge to predict the apparition of this complication.
2. Dubei L, Strat V. Algoritm de tratament minim invaziv al chistului hidatic hepatic, Jurnalul de Chirurgie (Iași) 2010: 6(1): 3-9.
3. Agudelo Higuita NI, Brunetti E, McCloskey C. Cystic Echinococcosis, J Clin Microbiol 2016; 54(3): 518-523 / doi: 10.1128/JCM.02420-15.
4. Derbel F, Mabrouk MB, Hamida MBH et al. Hydatid Cysts of the Liver - Diagnosis, Complications and Treatment, Abdominal Surgery, Prof. Fethi Derbel (Ed.), InTech / doi:10.5772/48433.
5. Roșca Ș, Silistraru I, Timofte DV, et al. The patients and healthcare staff perception on the protection of patients data and rights by professional secrecy in Romania. Rom J Leg Med 2020; 28: 68-75.
6. Roşca Ş, Silistraru I, Bulgaru-Iliescu D, et al. Patients’ rights and patients’ data protection in the Romanian health system: ready for the change? International Journal of Medical Dentistry 2019, 23(3): 348-352.
7. Akcan A, Sozuer E, Akyildiz H, Ozturk A, Atalay A, Yilmaz Z. Predisposing factors and surgical outcome of complicated liver hydatid cysts. World J Gastroenterol 2010; 16(24): 3040-3048.
8. Malik K, Dua A. Albendazole. In: Stat Pearls (Internet). Treasure Island (fL): StatPearls Publishing; 2022.
9. Anton E, Rotaru A, Covatariu D, et al. Links between extremely high frequency electromagnetic waves and their biological manifestations. Archives of Biological Sciences 2015; 67(00): 49-49 / doi: 10.2298/ ABS140228049A
10. Speich B, Ali SM, Ame SM, et al. Efficacy and safety of albendazole plus ivermectin, albendazole plus mebendazole, albendazole plus oxantel pamoate, and mebendazole alone against Trichuris trichiura and concomitant soil-transmitted helminth infections: a four-arm, randomized controlled trial. Lancet Infect Dis 2015; 15(3): 277-284.
11. Xing F, Ye H, Yang J, et al. Fatal pancytopenia due to albendazole treatment for strongyloidiasis. ID Cases 2018; 12: 112-116.
12. Torgerson PR, Robertson LJ, Enemark HL, et al. Source attribution of human echinococcosis: A systematic review and meta-analysis. PLoS Negl Trop Dis 2020; 14(6): e0008382 / doi: 10.1371/ journal.pntd. 0008382.
13. Aursulesei V, Vasincu D, Timofte D, et al. New mechanisms of vesicles migration. Gen Physiol Biophys 2016; 35(3): 287-298 / doi: 10.4149/gpb_2015048
14. Akbulut S, Sahin TT. Comment on closed cyst resection for liver hydatid Disease: a new standard. J Gastrointest Surg 2020; 24: 1899-1900.
15. Kilic M, Yoldas O, Koc M, et al. Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter? Am J Surg 2008; 196(5): 732-735 / doi: 10.1016/j.amjsurg. 2007.07.034.
16. El Nakeeb A, Salem A, El Sorogy M, et al. Cystobiliary communication in hepatic hydatid cyst: predictors and outcome. Turk J Gastroenterol 2017; 28(2):125-130 / doi: 10.5152/tjg.2017.17553.
17. Demir S, Ilikan GB, Erturk A, et al. A serious complication of liver hydatid cysts in children: cyst biliary fistulas. Pediatr Surg Int 2020; 36(5): 611-620 / doi: 10.1007/s00383-020-04637-9.
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