Advertisement

Closed Cyst Resection for Liver Hydatid Disease: a New Standard

  • Clément JulienEmail author
  • Yves Patrice Le Treut
  • Stéphane Bourgouin
  • Anaïs Palen
  • Jean Hardwigsen
Original Article
  • 8 Downloads

Abstract

Background

Although radical resections are recommended for the surgical management of liver hydatid disease (LHD), whether closed (CCR) or opened (OCR) cyst resections should be performed remains unclear. The aim of this study was to compare the postoperative and long-term outcomes of CCR and OCR for primary and recurrent LHD.

Materials and Methods

Medical charts of patients who underwent surgery at a single centre were retrospectively reviewed and compared with respect to major postoperative complications and recurrence rates.

Results

Seventy-nine CCRs and 37 OCRs were included. The major morbidity rates were 19% and 5% in the OCR and CCR groups, respectively (P = 0.036). In multivariate analysis, OCR (P = 0.030, OR = 5.37) and the operative time (P < 0.001, OR = 18.88) were the only independent predictors of major complications. The 5-year and 10-year recurrence rates were both 0% in the CCR group compared to 18% and 27%, respectively, in the OCR group (P < 0.001). The mean time to recurrence was 10.5 (± 8) years.

Discussion

Closed cyst resection for LHD is a safe and effective approach with a low risk of recurrence. Considering that recurrence could appear more than 10 years after surgery, follow-up of patients should be adapted.

Keywords

Hepatic hydatidosis Liver Parasitic diseases 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Moro P., Schantz PM. Echinococcosis: a review. Int J Infect Dis. 2009;13(2):125–33.  https://doi.org/10.1016/j.ijid.2008.03.037.CrossRefPubMedGoogle Scholar
  2. 2.
    Torgerson PR., Devleesschauwer B., Praet N., Speybroeck N., Willingham AL., Kasuga F., et al. World Health Organization Estimates of the Global and Regional Disease Burden of 11 Foodborne Parasitic Diseases, 2010: A Data Synthesis. PLOS Med. 2015;12(12):e1001920.  https://doi.org/10.1371/journal.pmed.1001920.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Sielaff TD., Taylor B., Langer B. Recurrence of hydatid disease. World J Surg. 2001;25(1):83–6.CrossRefGoogle Scholar
  4. 4.
    Demirci S., Eraslan S., Anadol E., Bozatli L. Comparison of the results of different surgical techniques in the management of hydatid cysts of the liver. World J Surg. 1989;13(1):88–90; discussion 90-91.CrossRefGoogle Scholar
  5. 5.
    Kayaalp C., Bostanci B., Yol S., Akoglu M. Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications. Am J Surg. 2003;185(2):175–9.CrossRefGoogle Scholar
  6. 6.
    Pang Q., Jin H., Man Z., Wang Y., Yang S., Li Z., et al. Radical versus conservative surgical treatment of liver hydatid cysts: a meta-analysis. Front Med. 2017:669–75.  https://doi.org/10.1007/s11684-017-0559-y.CrossRefGoogle Scholar
  7. 7.
    Yüksel O., Akyürek N., Şahin T., Salman B., Azili C., Bostanci H. Efficacy of radical surgery in preventing early local recurrence and cavity-related complications in hydatic liver disease. J Gastrointest Surg. 2008;12(3):483–9.  https://doi.org/10.1007/s11605-007-0301-1.CrossRefPubMedGoogle Scholar
  8. 8.
    Secchi MA., Pettinari R., Mercapide C., Bracco R., Castilla C., Cassone E., et al. Surgical management of liver hydatidosis: A multicentre series of 1412 patients. Liver Int. 2010;30(1):85–93.  https://doi.org/10.1111/j.1478-3231.2009.02116.x.CrossRefPubMedGoogle Scholar
  9. 9.
    El Malki HO., Souadka A., Benkabbou A., Mohsine R., Ifrine L., Abouqal R., et al. Radical versus conservative surgical treatment of liver hydatid cysts. Br J Surg. 2014;101(6):669–75.  https://doi.org/10.1002/bjs.9408.CrossRefPubMedGoogle Scholar
  10. 10.
    Bourgeon R., Mouuiel J. The merits of radical surgery in the treatment of hydatid cysts of the liver. Memoires Acad Chir Fr. 1964;90:355–61.Google Scholar
  11. 11.
    von Elm E., Altman DG., Egger M., Pocock SJ., Gøtzsche PC., Vandenbroucke JP., et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. Ann Intern Med. 2007;147(8):573.  https://doi.org/10.7326/0003-4819-147-8-200710160-00010.CrossRefGoogle Scholar
  12. 12.
    Gharbi HA., Hassine W., Brauner MW., Dupuch K. Ultrasound examination of the hydatic liver. Radiology. 1981;139(2):459–63.  https://doi.org/10.1148/radiology.139.2.7220891.CrossRefPubMedGoogle Scholar
  13. 13.
    Sbihi Y., Rmiqui A., Rodriguez-Cabezas MN., Orduña A., Rodriguez-Torres A., Osuna A. Comparative sensitivity of six serological tests and diagnostic value of ELISA using purified antigen in hydatidosis. J Clin Lab Anal. 2001;15(1):14–8.CrossRefGoogle Scholar
  14. 14.
    Brunetti E., Kern P., Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1–16.  https://doi.org/10.1016/j.actatropica.2009.11.001.CrossRefPubMedGoogle Scholar
  15. 15.
    Dindo D., Demartines N., Clavien P-A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefGoogle Scholar
  16. 16.
    Strasberg SM. Nomenclature of hepatic anatomy and resections: A review of the Brisbane 2000 system. J Hepatobiliary Pancreat Surg. 2005;12(5):351–5.  https://doi.org/10.1007/s00534-005-0999-7.CrossRefPubMedGoogle Scholar
  17. 17.
    Dziri C., Haouet K., Fingerhut A., Zaouche A. Management of Cystic Echinococcosis Complications and Dissemination: Where is the Evidence? World J Surg. 2009;33(6):1266–73.  https://doi.org/10.1007/s00268-009-9982-9.CrossRefPubMedGoogle Scholar
  18. 18.
    Gollackner B., Längle F., Auer H., Maier A., Mittlböck M., Agstner I., et al. Radical Surgical Therapy of Abdominal Cystic Hydatid Disease: Factors of Recurrence. World J Surg. 2000;24(6):717–21.  https://doi.org/10.1007/s002689910115.CrossRefPubMedGoogle Scholar
  19. 19.
    Motie MR., Ghaemi M., Aliakbarian M., Saremi E. Study of the Radical vs. Conservative Surgical Treatment of the Hepatic Hydatid Cyst: A 10-Year Experience. Indian J Surg. 2010;72(6):448–52.  https://doi.org/10.1007/s12262-010-0163-8.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Tagliacozzo S., Miccini M., Bonapasta SA., Gregori M., Tocchi A. Surgical treatment of hydatid disease of the liver: 25 years of experience. Am J Surg. 2011;201(6):797–804.  https://doi.org/10.1016/j.amjsurg.2010.02.011.CrossRefPubMedGoogle Scholar
  21. 21.
    Gupta N., Javed A., Puri S., Jain S., Singh S., Agarwal AK. Hepatic Hydatid: PAIR, Drain or Resect? J Gastrointest Surg. 2011;15(10):1829–36.  https://doi.org/10.1007/s11605-011-1649-9.CrossRefPubMedGoogle Scholar
  22. 22.
    Voros D., Kalovidouris A., Gouliamos A., Vlachos L., Danias N., Papadimitriou J. The real incidence of extracapsular (satellite) cysts of liver echinococcus. HPB Surg World J Hepatic Pancreat Biliary Surg. 1999;11(4):249–52.CrossRefGoogle Scholar
  23. 23.
    Mottaghian H., Saidi F. Postoperative recurrence of hydatid disease. Br J Surg. 1978;65(4):237–42.CrossRefGoogle Scholar
  24. 24.
    Kern P., Menezes da Silva A., Akhan O., Müllhaupt B., Vizcaychipi KA., Budke C., et al. The Echinococcoses. Advances in Parasitology, vol. 96. Elsevier; 2017. p. 259–369.Google Scholar
  25. 25.
    Atmatzidis KS., Pavlidis TE., Papaziogas BT., Mirelis C., Papaziogas TB. Recurrence and long-term outcome after open cystectomy with omentoplasty for hepatic hydatid disease in an endemic area. Acta Chir Belg. 2005;105(2):198–202.CrossRefGoogle Scholar
  26. 26.
    Lv H., Jiang Y., Peng X., Zhang S., Wu X., Yang H., et al. Subadventitial cystectomy in the management of biliary fistula with liver hydatid disease. Acta Trop. 2015;141:223–8.  https://doi.org/10.1016/j.actatropica.2014.06.006.CrossRefPubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2020

Authors and Affiliations

  1. 1.Department of Surgery and Liver TransplantationHôpital de la TimoneMarseilleFrance
  2. 2.Department of SurgeryHôpital Sainte AnneToulonFrance
  3. 3.Aix Marseille UniversityMarseilleFrance

Personalised recommendations