Liver hydatidosis: reasoned indicationsof surgical treatment. Comparison betweenconservative and radical techniquesRetrospective study

Liver hydatidosis is a focal benign parasitic disease that still cause high rate of morbidity particularly in the Mediterraneanarea. A retrospective study comparing conservative and radical techniques in a General and Urgent Surgery operativeunit was carried out in order to find signs of its surgical treatment.A total of 50 patients, 24 men and 26 women, who experienced a surgical treatment from 2000 to 2011, participated,and through the Fisher’s Exact Test characteristics of the cysts, post-operative complications and relapse were compared.As a result, 29 patients undertook conservative surgery, while 21 radical surgery.There was a relationship between characteristics of the cysts and the technique chosen, (p<0.001). Likewise, wheneverthe diameter was smaller than 10cm or localized in the left lobe a radical technique was used. Conversely, a conservativetechnique was used when the diameter was bigger than 10 cm or they were localized in the right lobe or complicatedby intra-biliary or intra-peritoneal rupture as well as in contiguity with major vascular and biliary structures.In this regard, while the post-operative morbidity was related to the conservative techniques (p<0.004), the relapses tendedto not be related to any techniques in our case (p<0.14).In conclusion, in a non hepato-bilio-pancreatic center a radical surgery including liver resection is suggested for left lobe’scysts, while a conservative technique tends to be more effective for right lobe’s cysts mainly if complex. Consequently,patients with complicated presentation could explain why conservative treatment causes higher rate of morbidity.