Surgical Management Of Hydatic Liver Cysts: About 2200 Cysts Which 1400 Complicated
Seance of wednesday 28 may 2025 (Communications libres)
DOI number : 10.26299//2025.20.03
Abstract
Introduction: Despite the unquestionable contribution of imaging in the diagnosis of the cyst hydatic, it is discovered at the stage of complication in more than 90% of the cas.il remains a serious pathology, evidenced by its morbidity .
Material and methods: This retrospective study relates on the analysis of 2200 hydatiques cysts treated over a period of 50 years. It's 550 men and women 1650. The average age was 40 years and ranged from 7 to 88 years old, and a peak of frequency between 25 and 35 years old.
Results: 67% were located on the right liver, the cyst was unique in 59% of cases, location double in 20% and multiple in 21% of the cas.42% patients had a lung localization associated, 29 splenic, 26 a malignant hydatidosis, 17 mesenteric and 9 ovarian.
Exploration 800 cysts were healthy (type I), 310 suppures, 1010 had a biliary fistula, broken in the biliary and 12 breaking 67 in the peritoneum.
All techniques were practised, 7 marsupialisations, 2 posadas and 2 external drainage. 94 perikystoresections, 42 kystectomies ideal, 10 left hepatectomies and 254 perikystectomies, the rest either 1800 had a resection of the protruding dome, noted that 55 patients have been treated by coelioscopy. Drainage has affected 468 patients divided into 10% technique of Guedj, 24% upholstery and 60% an aspirative drainage. Plasties of fillers were performed 98 times. Treatment of biliary fistulas is more nuanced, blinded systematically before 1976, we let them open with intracystic drainage with or without biliary drainage
We had 6 deaths (3 deaths by pulmonary embolism, 2 by anaphylac choc and 1 by heart attack) and morbidity occurred in 35% of patients, suppuration of the residual cavity, inexhaustible biliary fistula and bleeding of the surgical site. The long term follow-up allowed to re-operate 21% of patients for a recurrence or secondary location. The length of hospital stay increased from 6 days for simple cysts to 57 days for complicated cysts
Conclusion: Hydatiques cysts are often allowed to stage complication and it are these cysts that pose the most therapeutic and post-operative problems, must diagnose and treat at an early stage or a conservative treatment is sufficient.
R.GRAÏCHI – Z.GUEZZEN – Y.IKKACHE – B.KRELIL
Department of general and oncologic surgery – CHUOran
Oran - Algeria
Material and methods: This retrospective study relates on the analysis of 2200 hydatiques cysts treated over a period of 50 years. It's 550 men and women 1650. The average age was 40 years and ranged from 7 to 88 years old, and a peak of frequency between 25 and 35 years old.
Results: 67% were located on the right liver, the cyst was unique in 59% of cases, location double in 20% and multiple in 21% of the cas.42% patients had a lung localization associated, 29 splenic, 26 a malignant hydatidosis, 17 mesenteric and 9 ovarian.
Exploration 800 cysts were healthy (type I), 310 suppures, 1010 had a biliary fistula, broken in the biliary and 12 breaking 67 in the peritoneum.
All techniques were practised, 7 marsupialisations, 2 posadas and 2 external drainage. 94 perikystoresections, 42 kystectomies ideal, 10 left hepatectomies and 254 perikystectomies, the rest either 1800 had a resection of the protruding dome, noted that 55 patients have been treated by coelioscopy. Drainage has affected 468 patients divided into 10% technique of Guedj, 24% upholstery and 60% an aspirative drainage. Plasties of fillers were performed 98 times. Treatment of biliary fistulas is more nuanced, blinded systematically before 1976, we let them open with intracystic drainage with or without biliary drainage
We had 6 deaths (3 deaths by pulmonary embolism, 2 by anaphylac choc and 1 by heart attack) and morbidity occurred in 35% of patients, suppuration of the residual cavity, inexhaustible biliary fistula and bleeding of the surgical site. The long term follow-up allowed to re-operate 21% of patients for a recurrence or secondary location. The length of hospital stay increased from 6 days for simple cysts to 57 days for complicated cysts
Conclusion: Hydatiques cysts are often allowed to stage complication and it are these cysts that pose the most therapeutic and post-operative problems, must diagnose and treat at an early stage or a conservative treatment is sufficient.
R.GRAÏCHI – Z.GUEZZEN – Y.IKKACHE – B.KRELIL
Department of general and oncologic surgery – CHUOran
Oran - Algeria