According to the authors, the question of choosing the most effective surgical approach for treating liver echinococcosis remains open. Previously, preference was given to organ-preserving methods; however, there has recently been an increase in the use of radical surgeries for treating hydatid echinococcosis.
The aim of this study was to analyze both the immediate and long-term results of organ-preserving and radical surgical interventions.
Within the framework of the study, 359 patients suffering from hydatid liver echinococcosis were analyzed, of which 299 (83.3%) had primary echinococcosis, and 60 (16.7%) had recurrent cases. Among the participants, 176 were men (49%) and 183 were women (51%).
Organ-preserving surgeries were performed on 232 patients (64.4%). The postoperative mortality rate was 0.9% (2 cases). Complications after surgery occurred in 44 individuals (18.9%), and disease recurrences were recorded in 12 patients (5.2%). The most common complication was a residual cavity, identified in 28 patients (12.1%), of which 10 (4.3%) experienced suppuration.
Radical surgeries were performed on 127 individuals, with fatalities in 2 cases (1.6%). Postoperative complications were observed in 14 patients (11%), with hemorrhagic and biliary complications predominating in 9 of them. Intra-abdominal bleeding was recorded in 5 individuals: in 4 cases, it was moderate and successfully managed with conservative therapy, while one patient required reoperation. Additionally, two patients developed liver failure after complex liver resections, but both cases were successfully managed with medication.
In conclusion, the authors emphasize that the radical removal of the fibrous capsule along with pericystic tissues (pericystectomy and liver resection) demonstrates better results in both the short-term and long-term perspectives in the surgical treatment of liver echinococcosis.
