THE IMPACT OF VARIOUS SURGICAL TECHNIQUES ON MORBIDITY AND HOSPITALIZATION PERIOD IN HYDATID CYST OF LIVER
E OKAN HAMAMCI, HASAN BESİM, KEMAL RAŞA, ATİLA KORKMAZ
Ankara Numune Eğitim ve Araştırma Hastanesi 6. Cerrahi Kliniği, ANKARA
In this study, patients with complicated and uncomplicated liver hydatid cysts were evaluated in terms of the surgical procedures performed, hospitalization period and complications. When total cystectomy; the best operation of choice is not possible in a liver hydatid cyst, surgical options for the cyst and the remaining cavity after evacuation is still obscure as none of the procedures has perfect post-operative results. In this retrospective study, 277 patients operated for liver hydatid cysts between 1983 and 1999 were reviewed. 216 patients had uncomplicated cysts whereas 61 had complicated cysts. Post-operative complications and hospitalization periods were compared between two groups, The shortest hospitalization period and lowest morbidity was in patients with o total cystectomy of an uncomplicated cyst. Post-operative morbidity rate was 39.7% in patients that cavitary drainage was performed after partial cystectomy and 18.2% in the non-drained patients. Hospitalization periods were 12,3 and 8,2 days respectively. In the complicated group, post-operative morbidity was 29.6% for patients with omentopexy and 58.8% for the cavitary drainage group. Hospitalization period was not different between these two groups. In conclusion partial cystectomy + omentopexy or left-open methods are the best alternatives of total cystectomy in uncomplicated cysts. In a patient with a complicated cyst however cavitary drainage can be performed although omentopexy can lower subsequent complications.
Keywords: HYDATIDCYST, LIVER, DRAINAGE, SURGICAL TREATMENT