Management of Liver Hydatid Cysts: A Retrospective Analysis of 293 Surgical Cases from Southern Iran

Abstract

Background. The current study aimed to evaluate the therapeutic features and complications of liver hydatid cyst in patients who underwent surgery for cystic echinococcosis (CE) in Fars province, southern Iran. Methods. A total of 293 patients who underwent surgery for liver hydatid cyst from 2004 to 2018 in Fars province, southern Iran, were retrospectively evaluated. The clinical records of patients were reviewed, and the demographic and clinical characteristics of each patient were assessed. Results. Of the total of 293 cases, 178 (60.9%) were females and 115 (39.1%) were males. The mean age of the subjects was 37.22 (±20.55) years. The mean size of the liver hydatid cyst was 9.18 (±4.365) cm. Of the 293 patients studied, 227 (77.4%) had hydatid cysts only in the liver, while 55 (9.4%) had both liver and lung cysts. More than half of the liver cysts (65.9%) were located in the right portion of the liver (segment 5 to 8). Of the 293 cases, 52 (17.7%) underwent radical surgery, while 241 (82.3%) underwent conservative surgery. Recurrence of hydatid cyst was recorded in 46 (15%) of cases. Patients who were treated with radical surgery in comparison with those who had conservative surgery had a lower recurrence rate but a longer duration of hospital stay ( $P<0.05$ ). Conclusion. Recurrence remains as one of the major challenges in the management of hydatid cyst. Radical surgery reduces the chance of recurrence, although this procedure increases the length of hospital stay.