Comparing two different surgical approaches (Conservative and Radical) in combination with Albendazole for the treatment of hydatid cyst. A 30-year retrospective study from a large series of patients.
Abstract
Abstract
Background: Hydatid disease management varies from medical treatment or percutaneous drainage to different surgical procedures. The aim of this study is to evaluate different surgical approaches with a specific administration of Albendazole.
Methods: One hundred fifty four patients underwent conservative surgery (Group A, unroofing with marsupialization, capitonnage, omentoplasty or external drainage) and seventy five patients radical surgery (Group B, pericystectomy or hepatectomy). Albendazole was given 5 days preoperatively in both groups and continued for 1 month postoperatively only in patients of Group A with viable protoscolices at the time of operation.
Results: No deaths occurred intraoperatively or during the first 30 postoperative days in both Groups. The mean hospital stay in Group A was 10.8 days (range 7-43) while in Group B was 11.7 days (range 7-46). Only one patient in Group A (0.6%) having viable protoscolices at the time of operation developed relapse of the disease after 52 months of follow-up. The complication rate in Group A was 23.3 % whereas in Group B was 30.6%. No statistical differences were observed in terms of hospitalization, complication and relapse rate (p=0.43, 0.83 and 0.48 respectively). The only independent variable that could affect the treatment is the diameter of the cysts (B=0.442, P<0.001).
Conclusions: Conservative and radical surgery have almost zero recurrence when they are combined with a specific administration of Albendazole. Furthermore we deemed that unroofing procedure with the administration of Albendazole five days prior and one month postoperatively only in the presence of viable protoscolices should be the first line procedure for most of Hydatid liver disease as the procedure is simpler, easier to perform and requires no advanced surgical skills or a certain degree of experience.
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DOI: http://dx.doi.org/10.18103/imr.v5i4.816
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