EFFECTIVENESS OF OBLITERATION PROCEDURES IN THE TREATMENT OF HYDATID DISEASE OF THE LIVER

Abstract

The surgical treatment of hydatid cyst of liver (HCL) can be done by various techniques. In this study, the various methods of treatment, external drainage, obliteration (introflexion, capitonnage and omentoplasty) and radical (pericystectomy, partial hepatectomy) procedures, in the HCL was evaluated according to duration of hospitalization and the rates of morbidity, mortality and recurrence. Sixty-four patients were operated with the diagnosis of HCL between January 1986-December 1990. As a treatment method, drainage procedures were performed in 36 patients, obliteration in 21 and radical procedures in 7. In this period, mean duration of hospitalization, morbidity, mortality and recurrence rates were 15.3 ( 6.2 days, 37.5%, 1.5% and 6.2%. Mean duration of hospitalization, morbidity and recurrence rates were 17.1 (6.7 days, 61.1%, 8.3% in drainage group and 12.9 (4.3 days, 9.5% and 3.5% in patients treated by obliteration and radical procedures respectively. On the basis of these findings a prospective series of 64 patients was studied between January 1991-1996. In this period drainage was only performed in 5 patients who had infected or perforated cysts, pericystectomy in 8 and obliteration procedures in 51. Mean duration of hospitalization, morbidity, mortality and recurrence rates were 9.2 ( 3.6 days, 18.7%, 1.5% and 3.1%. Mean duration of hospitalization and morbidity rate were 7.5 ( 2.8 days and 12.5% in radical group and 8.4 ( 3.3 days and 9.5% in obliteration procedures group respectively. The results of this study; drainage procedure should be performed only in infected HCL. Resection procedures are too radical and extensive procedures far a benign lesion and they should be reserved for located peripherally, pedunculated, multiple left lobe HCL or cyst caused by Echinococcus alveolaris. Obliteration procedures are simple and safe methods for the treatment of HCL and they have low morbidity, mortality and recurrence rates.