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Surgical Management of Liver Hydatid Disease: Subadventitial Cystectomy versus Resection of the Protruding Dome

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Abstract

Background

The aim of this study was to compare postoperative outcome and long-term results after management of liver hydatid cysts (LHC) by subadventitial cystectomy (SC) and resection of the protruding dome (RPD) in two tertiary liver surgery centers.

Methods

Medical records of 52 patients who underwent SC in one center, and 27 patients who underwent RPD in another center between 1991 and 2011 were reviewed. Patients underwent long-term follow-up, including serology tests and morphological examinations.

Results

Postoperative mortality was nil. The rate of severe morbidity was 7.7 and 22 % (p = 0.082), while the rate of serological clearing-up was 20 and 13.3 % after SC and RPD, respectively (p = 1.000). After a mean follow-up of 41 months (1–197), four patients developed a long-term cavity-related complication (LTCRC) after RPD (including one recurrence) and none after SC (p = 0.012). All LTCRCs occurred in patients with hydatid cysts located at the liver dome; three required an invasive procedure by either puncture aspiration injection re-aspiration (N = 1) or repeat surgery (N = 2).

Conclusions

RPD exposes to specific LTCRC, especially when hydatid cysts are located at the liver dome, while SC allows ad integrum restoration of the operated liver. Therefore, SC should be considered as the standard surgical treatment for LHC in experienced hepato-pancreato-biliary centers.

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Funding

No grant support was received for the research reported.

Conflicts of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of General and Digestive Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, Université Lyon 1, EMR 3738, 103 Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France

    Kayvan Mohkam, Benjamin Darnis, Christian Ducerf & Jean-Yves Mabrut

  2. Department of Internal Medicine, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium

    Leila Belkhir

  3. Department of Parasitology and Mycology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France

    Martine Wallon & François Peyron

  4. Department of Hepato-biliary and Pancreatic Surgery, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium

    Jean-François Gigot

Authors
  1. Kayvan Mohkam
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  2. Leila Belkhir
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  3. Martine Wallon
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  4. Benjamin Darnis
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  6. Christian Ducerf
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  8. Jean-Yves Mabrut
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Correspondence to Jean-Yves Mabrut.

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Mohkam, K., Belkhir, L., Wallon, M. et al. Surgical Management of Liver Hydatid Disease: Subadventitial Cystectomy versus Resection of the Protruding Dome. World J Surg 38, 2113–2121 (2014). https://doi.org/10.1007/s00268-014-2509-z

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  • DOI: https://doi.org/10.1007/s00268-014-2509-z

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