[Surgical treatment of hepatic hydatidosis. Analysis of results of conservative and radical surgery in our experience].

The authors review a series of 194 cases of hepatic hydatidosis submitted to surgery over the period from July 1973 to December 2001, comparing the results of conservative and radical operatins. In this period we performed 164 conservative operations (140 indirect marsupialisations, 5 delaminations with capitonnage of the residual cavity and 19 partial pericystectomies), 26 total pericystectomies and 4 liver resections. The main outcome measures analysed were postoperative hospital stay, mortality, morbidity and recurrence rates. The median postoperative hospital stay was 17.5 days for conservative operations and 12.5 days for radical surgical procedures. No deaths occurred in either group. The morbidity was 26.8% after conservative treatment (34 biliary fistulas, 3 cases of jaundice, 5 residual cavity infections and 2 subphrenic abscesses) and 13.3% after total pericystectomy and liver resection (3 wound infections and 1 pleural effusion). Recurrences occurred only in the group treated by marsupialisation (12/140 = 8.5%) and were managed by total pericystectomy in 5 cases and by a second drainage procedure in 7. The surgical procedure for the treatment of hepatic hydatidosis should be tailored to the needs of each patient, depending on the size, location and complications of the cyst and high surgical risk should be avoided in view of the benign nature of the disease. No deaths occurred in either of our patient groups, but postoperative hospital stay, morbidity and recurrence rates were better in those undergoing radical treatment.