Skip to main content

Advertisement

SpringerLink
Log in

Is Radical Surgery Feasible in Liver Hydatid Cysts in Contact with the Inferior Vena Cava?

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Cysts in contact with the inferior vena cava (IVC) represent a challenge for hepato-pancreatico-biliary surgeons. Although the literature on the topic is scarce, the most widely accepted approach is conservative surgery. Partial cyst resection is recommended, because radical resection is considered a high-risk procedure.

Study design

This was a retrospective study over the period January 2007–December 2012. We operated on 103 patients with liver hydatidosis. A total of 32 patients (31 %) had a liver cyst in contact with the IVC. We proposed a cyst classification based on location of the cyst and length of contact and degrees of involvement of the IVC.

Results

Median size of the contacting cyst measured by computed tomography (CT) was 12 cm. On CT, median length of contact with the IVC was 37 mm. The median degree of involvement was 90°. Radical surgery was performed in 20 patients (62.5 %). No IVC resection was done. Morbidity rate was 28 %, and mortality was 3 %. In follow-up (median 27 months), no relapses or problems related to IVC flow were detected. Postoperative stay and transfusion rate were higher in the conservative surgery group, but these patients presented fewer complications. There was no relationship between circumferential grades and length of contact with the IVC and the type of surgery performed.

Conclusions

Liver hydatid cysts in contact with the IVC are large cysts usually located in the right liver. They do not normally cause clinical symptoms related to IVC contact. Radical surgery is feasible, and was performed in 60 % of our series, but it is technically demanding. We propose a classification of cysts in contact with the IVC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ramia JM, Figueras J, De la Plaza R, García-Parreño J (2012) Cysto-biliary communication in liver hydatidosis. Langenbecks Arch Surg 397:881–887

    Article  PubMed  CAS  Google Scholar 

  2. Laalim S, Ibn Majdoub Hassani K, Toughai I, Oussaden A, Kamaoui I, Mazaz K, Taleb KA (2011) Hydatic cyst of the liver ruptured into the inferior vena cava (in French). Pan Afr Med J 9:9

    PubMed  PubMed Central  Google Scholar 

  3. Gruttadauria S, Luca A, Cintorino D, Doria C, Scott VL, Marino IR (2003) Hepatic hydatid cyst causing thrombosis of the inferior vena cava and complicated by hemofilia. Dig Dis Sci 48:358–364

    Article  PubMed  Google Scholar 

  4. Blasco MA, Corrales M, Poza A, Sanchez JA (1993) Anaphylactic shock caused by spontaneous ruptura of hepatic hydatid cyst into inferior vena cave (in Spanish). Rev Clin Esp 192(1):49–50

    Google Scholar 

  5. Karunajeewa HA, Jones RM, Hardy KJ, Buxton BF, Richards MJ (2002) Hydatid disease invading the inferior vena cava: successful combined medical and surgical treatment. ANZ J Surg 72:159–160

    Article  PubMed  CAS  Google Scholar 

  6. Bahamondes JC, Sandoval P, Losada H, Meriño G, Salaman J, Silva A, Mora J (2010) Quiste hidatídico hepático complicado con invasión a vena cava inferior y embolización de membranas hidatídicas a aurícula derecha. Caso Clínico. Rev Chil Cir 62:179–182

    Article  Google Scholar 

  7. Rajagopal KV, Bishwas R (2002) Hydatid cyst of the liver presenting as an inferior vena cava obstruction. J Clin Ultrasound 30:114–116

    Article  PubMed  CAS  Google Scholar 

  8. Rossi IA, Delay D, Qanadii SD, Jaussi A (2009) Inferior vena cava syndrome due to Echinococcus multilocularis. Echocardiography 26:842–846

    Article  PubMed  Google Scholar 

  9. Kayaalp C (2007) Hydatid liver cyst ruptures into vena cava inferior. Neth J Med 65(10):402–403

    PubMed  CAS  Google Scholar 

  10. Akgun V, Battal B, Karaman B, ors F, Deniz O, Daku A (2011) Pulmonary artery embolism due to a ruptured hepatic hydatid cyst: clinical and radiological imaging findings. Emerg Radiol 18:437–439

    Article  PubMed  Google Scholar 

  11. Mekeel KL, Hemming AW (2007) Combined resection of the liver and the inferior vena cava for hydatid disease. J Gastrointest Surg 11:1741–1743

    Article  PubMed  Google Scholar 

  12. Dziri C, Haouet K, Fingerhut A (2004) Treatment of hydatid cyst of the liver: where is the evidence? World J Surg 28:731–736. doi:10.1007/s00268-004-7516-z

    Article  PubMed  Google Scholar 

  13. Brunetti E, Kern P, Vuitton DA, Writing Panel for the WHO-IWGE (2010) Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 114:1–16

    Article  PubMed  Google Scholar 

  14. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  15. Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L et al (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149:680–688

    Article  PubMed  Google Scholar 

  16. Ramia JM, Ruiz-Gomez F, De la Plaza R, Veguillas P, Quiñones J, García-Parreño J (2012) Ambispective comparative study of two surgical strategies for liver hydatidosis. World J Gastroenterol 18:546–550

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hepato-Bilio-Pancreatic Surgical Unit, Department of Surgery, Guadalajara University Hospital, C/General Moscardó 26, 5-1, 28020, Guadalajara, Madrid, Spain

    J. M. Ramia, R. De la Plaza & J. García-Parreño

  2. Hepato-Bilio-Pancreatic Surgical Unit, Department of Surgery, Hospital Miguel Servet, Zaragoza, Spain

    A. Serrablo & J. Esarte

  3. Department of Radiology, Guadalajara University Hospital, Guadalajara, Spain

    L. Gijón

  4. Department of Radiology, Hospital Miguel Servet, Zaragoza, Spain

    L. Sarria

  5. HPB Unit, Department of Surgery, IdIBGi, Hospital Josep Trueta, Girona, Spain

    J. Figueras

Authors
  1. J. M. Ramia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Serrablo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. De la Plaza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Esarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Gijón
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Sarria
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J. Figueras
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. García-Parreño
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. M. Ramia.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ramia, J.M., Serrablo, A., De la Plaza, R. et al. Is Radical Surgery Feasible in Liver Hydatid Cysts in Contact with the Inferior Vena Cava?. World J Surg 38, 2940–2945 (2014). https://doi.org/10.1007/s00268-014-2658-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-014-2658-0

Keywords

Search

Navigation