Radical versus conservative surgical treatment of liver hydatid cysts: A paired comparison analysis

• Published in: The American journal of surgery 2022-07, Vol.224 (1), p.190-195
• Main Authors: Farhat, Waad, Ammar, Houssem, Rguez, Arib, Harrabi, Fathia, Said, Mohamed Amine, Ghabry, Linda, Gupta, Rahul, Ben cheikh, Asma, Ghali, Hela, Ben Rajeb, Mohamed, Ben Mabrouk, Mohamed, Ben Ali, Ali
• Format: Article
• Language: English
• Subjects: Abdomen; Bile; Chemotherapy; Complications; Cysts; Dissection; Hospitals; Liver; Liver hydatid cyst; Liver resection /surgery/ hepatic echinococcosis; Medical records; Morbidity; Mortality; Patients; Postoperative; Surgery; Sutures; Ultrasonic imaging
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2021.12.014

The management of liver hydatid cysts (LHC) is complex and includes surgery, percutaneous drainage, chemotherapy and observation. Broadly, there are two types of surgical treatment for LHC - conservative surgery (CS) and radical surgery (RS). The purpose of this study was to compare the outcome of RS and CS. Data from all patients with LHC treated in Sahloul Hospital, between January 2000 and December 2019, were retrieved. To minimize selection bias, paired comparison analysis (PCA) was performed. A total of 914 patients were included in this study. RS and CS were performed in 284 and 630 patients, respectively. After PCA, 206 patients were included in each group. The incidence of intraoperative bleeding was significantly higher in the RS group. The overall morbidity was significantly lower in the RS group. Thity-four patients developed recurrence with significantly higher recurrence in CS group. RS is associated with fewer postoperative complications and lower recurrence rate compared to CS. RS may be the preferred procedure for LHC if the expertise is available. •The management of liver hydatid cysts (LHC) is controversial.•The purpose of this study was to compare the outcome of radical surgery (RS) and conservative surgery (CS).•RS is associated with fewer postoperative complications and lower recurrence rate compared to CS.•Most surgeons in endemic countries are using CS because it is easy, and the lack of studies showing the benefit of the RS.•RS may be the preferred procedure for LHC if the expertise is available.