radical vs. conservative surgical treatment of hepatic hydatid cyst: a 10- year experience

introduction: hepatic hydatid cyst is caused by echinococcosis granulosis. it is a major health problem in endemic areas. the modern treatment of hydatid cysts of the liver varies from surgical intervention to percutaneous drainage or medical therapy. a high rate of complications following percutaneous drainage, and ineffectiveness of medical therapy have shown not to be the definitive treatments for the disease. thus, surgery is still the best choice for the treatment of hydatid cyst of the liver. surgical treatment methods can be divided into radical and conservative approaches. there is controversy regarding efficacy of the two surgical methods. in this study, we aimed to present a retrospective evaluation of the two surgical methods in patients treated for the hepatic hydatid cyst. methods: this retrospective study reviewed medical records of 135 patients who underwent surgery for hepatic hydatid cyst from 1997 to 2007. surgery comprised conservative methods (evacuation of the cyst content and excision of the inner cyst layers) and radical methods (total excision of the cyst and removal of its outer layer). results: one hundred thirty five patients underwent liver surgery. conservative surgery was performed for 71 (53%), whereas, the remaining 64 patients (47%) underwent radical surgery. postoperative complications were 28% and 19%, respectively. recurrence of the cyst in the conservative and radical surgery groups was noted to be 12.5 and 1.5%, respectively. the mean length of hospital stay was shorter in the radical surgery group (5 vs. 15 days). conclusion: radical surgery may be the preferred treatment for the hepatic hydatid cyst because of its low rate of postoperative complications and recurrence, as well as short hospital stay. selection of the most appropriate treatment depends on the size, number, and location of the cyst(s), and presence of cystobiliary communications, and the availability of an experienced surgeon.