RISK FACTORS AND SURGICAL SOLUTIONS OF COMPLICATED LIVER HYDATID CYSTS
S. Busuioc (1*), N. Dănilă (2), C. Roata (1,3), O. Motaş (1), St. Mihalache (3), C. Dragomir (4)
(*) PhD student, “Gr. T. Popa”University of Medicine and Pharmacy, Iasi
(1) Anatomy Department, “Gr. T. Popa”University of Medicine and Pharmacy, Iasi
(2) First Surgical Clinic, “Gr. T. Popa”University of Medicine and Pharmacy, Iasi
(3) Surgery Clinic– “St. John” Hospital
(4) Third Surgery Clinic, “Gr. T. Popa”University of Medicine and Pharmacy, Iasi
Jurnalul de chirurgie 2011; 7 (4): 608-614
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Abstract:

Aim of this study was to evaluate the predisposing factors for peritoneal perforation and intrabiliary rupture and the effects of these complications on surgical outcome in liver hydatid disease. Material and Methods: A total of 254 patients with liver hydatid cysts who had undergone surgical treatment were evaluated retrospectively. Twelve patients with peritoneal perforation, 43 patients with spontaneous intrabiliary perforation, and 199 patients with noncomplicated hydatid cysts were treated in our clinics. Results: When the predisposing factors for complications were evaluated, younger age, superficial position, and larger cyst dimensions (P < 0.05) increased peritoneal perforation rates. It was shown that older age increased cyst dimensions, and presence of multiple and bilobar cysts increased intrabiliary rupture rates (P < 0.05). Partial pericystectomy and drainage was the most frequent surgical procedure in all groups (82.7%). The incidence of post-operative complications in the peritoneal perforated group, in the intrabiliary ruptured group, and in the noncomplicated group was 27.6%, 18.3% and 4.7%, respectively. When length of hospital stay was compared, there was no significant difference between the groups (P > 0.05). The overall recurrence rate was 4.3% (11 patients), but there was not any statistical difference among the patient groups (P = 0.13). Conclusion: In peritoneally perforated and intrabiliary ruptured cases, the most important steps are irrigation of the peritoneal cavity and clearance of the cystic material from the biliary tree.

KEY WORDS: COMPLICATED LIVER HYDATID CYSTS, PREDISPOSING FACTORS, SURGICAL TREATMENT, SURGICAL OUTCOME

Correspondence to: S. Busuioc, MD, PhD student, Anatomy Department, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, str. Universităţii, nr. 16