1 Sep 2014Article
Liver hydatidosis: reasoned indications of surgical treatment. Comparison between conservative and radical techniques. Retrospective study
Giuseppe Salamone 1Roberta Tutino 1Jenny Atzeni 1Leo Licari 1Nicola Falco 1Giuseppina Orlando 1Gaspare Gulotta 1
Affiliations
Article Info
1 Department of Surgical, Oncological and Oral Science, University of Palermo, Medical School, General Surgery and Emergency, Policlinico “Paolo Giaccone”, Palermo, Italy
Ann. Ital. Chir., 2014, 85(5), 422-430;
Published: 1 Sep 2014
Copyright © 2014 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Liver hydatidosis is a focal benign parasitic disease that still cause high rate of morbidity particularly in the Mediterranean area. A retrospective study comparing conservative and radical techniques in a General and Urgent Surgery operative unit 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, whenever the diameter was smaller than 10cm or localized in the left lobe a radical technique was used. Conversely, a conservative technique was used when the diameter was bigger than 10 cm or they were localized in the right lobe or complicated by 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 tended to 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’s cysts, 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.
Keywords
- Liver hydatidosis
- Parasitic diseases