Management of complex liver cystic hydatidosis: challenging benign diseases for the hepatic surgeon: A case series report from an endemic area

Hydatid cysts of the liver are benign lesions which require a wide range of surgical strategies for their treatment. We hypothesized that cysts larger than 15 cm, or compressing main vascular structures, or located in both hemilivers should be considered, as well as complicated cysts, in the categor...

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Bibliographic Details
Published in:Medicine (Baltimore) 2020-11, Vol.99 (48), p.e23435-e23435
Main Authors: Fancellu, Alessandro, Perra, Teresa, Vergari, Dario, Vargiu, Isabel, Feo, Claudio F, Cossu, Maria L, Deiana, Giulia, Porcu, Alberto
Format: Article
Language:English
Subjects:
Adult
Aged
Echinococcosis - diagnostic imaging
Echinococcosis - epidemiology
Echinococcosis - surgery
Echinococcosis, Hepatic - diagnostic imaging
Echinococcosis, Hepatic - epidemiology
Echinococcosis, Hepatic - surgery
Endemic Diseases
Female
Hepatectomy
Humans
Italy - epidemiology
Length of Stay
Male
Middle Aged
Observational Study
Postoperative Complications
Retrospective Studies
Tomography, X-Ray Computed
Young Adult
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Summary:Hydatid cysts of the liver are benign lesions which require a wide range of surgical strategies for their treatment. We hypothesized that cysts larger than 15 cm, or compressing main vascular structures, or located in both hemilivers should be considered, as well as complicated cysts, in the category of complex hydatid cysts.In a retrospective study including 55 patients, we evaluated the characteristics of complex hydatid cysts, and compared surgical outcomes between patients operated on for complex cysts (Complex Group) and those operated on for non-complex cysts (non-Complex Group).In the Complex Group, 19% of patients had cysto-biliary communication with recurrent cholangitis, 9.5% had cysts eroding the diaphragm or chest wall, or communicating with the bronchial tree, 31% had cysts with contact with main vascular structures, 11.9% had multiple bilobar cysts, 14.3% had giant cysts with organ displacement, and 14.3% had a combination of the above-mentioned types. Type of surgical treatment was different between the two groups (P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000023435