Surgical Management of Abdominal Hydatid Disease in Adults in Tertiary Care Hospital: A Prospective Observational Study
Authors/Creators
- 1. Senior Resident, Department of General Surgery, GMC, Srinagar
Description
Background: Treatment of hydatid cyst typically involves a combination of medical, radiological and surgical approaches. Surgery is the primary and gold standard for hydatid disease. Surgical techniques for hydatid disease are conservative and radical. Radical procedures are open cystectomy, near total open cystectomy, subadventitial cystectomy, non-anatomical liver resection, anatomic liver resection, cystectopericystectomy & total cystopericystectomy; additional procedures are lobectomy & cholecystectomy. Methods: This was a prospective observational study conducted in the postgraduate department of general surgery at SMHS hospital, Gmc Srinagar J&K India over period of 18 months. The study included 25 patients who met the specified inclusion & exclusion criteria. Ethical clearance was obtained from the institutional ethical committee prior to commencing the study. Once diagnosed, patients were counselled on further management and treatment opitions available at the hospital. Results: The mean age in our study was 32.1±11.50 with range of 18-65 years. the most common age group involved in this disease was 18-35years (72%), followed by 35-50 years(24%) and >50 years had 4%. in our study most of patients were females 15 cases (60%) and males 10 cases(40%). Male: Female ratio in our study was 1:1.5. Most common organ involved in our study, liver in 24 cases (96%) followed by spleen in 1 case (4%). In 24 cases (96%) single cyst were found and multiple cysts only in 1 case (4%) .Laparoscopic hydatid cystectomy (LHC) in 6 cases, Open hydatid cystectomy in 16 cases, open hydatid cystectomy with left lateral segmentectomy in 2 cases and open splenectomy in 1 case (4%) was done. External tube drainage for management of residual cavity was done in 11 cases (68.7%) followed by omentopexy in 2 cases (12.5%) capitonnage in 1 cases (16.2%) and primary repair of CBC with omentopexy. Wound infection was seen in 2 cases, prolonged drainage in 1 case, CBC in 1 case, and recurrence in 1 case. Conclusion: The surgical approach may vary depending on factors such as cyst location, size, presence of multiple cysts and cystobiliary communication (CBC).Hydatid cystectomy with external tube drainage is commonly used technique that offers effective management with less complication.
Abstract (English)
Background: Treatment of hydatid cyst typically involves a combination of medical, radiological and surgical approaches. Surgery is the primary and gold standard for hydatid disease. Surgical techniques for hydatid disease are conservative and radical. Radical procedures are open cystectomy, near total open cystectomy, subadventitial cystectomy, non-anatomical liver resection, anatomic liver resection, cystectopericystectomy & total cystopericystectomy; additional procedures are lobectomy & cholecystectomy. Methods: This was a prospective observational study conducted in the postgraduate department of general surgery at SMHS hospital, Gmc Srinagar J&K India over period of 18 months. The study included 25 patients who met the specified inclusion & exclusion criteria. Ethical clearance was obtained from the institutional ethical committee prior to commencing the study. Once diagnosed, patients were counselled on further management and treatment opitions available at the hospital. Results: The mean age in our study was 32.1±11.50 with range of 18-65 years. the most common age group involved in this disease was 18-35years (72%), followed by 35-50 years(24%) and >50 years had 4%. in our study most of patients were females 15 cases (60%) and males 10 cases(40%). Male: Female ratio in our study was 1:1.5. Most common organ involved in our study, liver in 24 cases (96%) followed by spleen in 1 case (4%). In 24 cases (96%) single cyst were found and multiple cysts only in 1 case (4%) .Laparoscopic hydatid cystectomy (LHC) in 6 cases, Open hydatid cystectomy in 16 cases, open hydatid cystectomy with left lateral segmentectomy in 2 cases and open splenectomy in 1 case (4%) was done. External tube drainage for management of residual cavity was done in 11 cases (68.7%) followed by omentopexy in 2 cases (12.5%) capitonnage in 1 cases (16.2%) and primary repair of CBC with omentopexy. Wound infection was seen in 2 cases, prolonged drainage in 1 case, CBC in 1 case, and recurrence in 1 case. Conclusion: The surgical approach may vary depending on factors such as cyst location, size, presence of multiple cysts and cystobiliary communication (CBC).Hydatid cystectomy with external tube drainage is commonly used technique that offers effective management with less complication.
Files
IJPCR,Vol16,Issue8,Article217.pdf
Files
(325.4 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:48bc36a2682a7e35cf2e570e10f82f98
|
325.4 kB | Preview Download |
Additional details
Dates
- Accepted
-
2024-07-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue8,Article217.pdf
- Development Status
- Active
References
- 1. Barnes SA, Lilliemoe KD. Liver abscess and hydatid cyst disease In: Zinner Mj-Schwatz S.I-Ellis it Maingots abd. Operation 10th edition, Stanford ,Appleton and large.1997;1513- 46 2. Aksu MF, Budak E, Ince U, Aksu C. Hydatid cyst of the ovary. Arch Gynecol Obstet. 1997; 261(1):51-3.3. Mc Manus OP, Zhang W, Li J, Bartley PB. Echinococcosis Lancet 2003; 362: 1295-304. 4. Ci-Peny J, MCmanus PD, Malcom J. Liver alveolar echinococcosis in China. Clinical aspect with relative basic research. World J Gastroenterol 2005; 11 :4611-17 5. Raether W, Hanel H. Epidemiology, Clinical manifestations and diagnosis of zoonotic cestode infection; an update Parasitol. Res 2003; 91: 412-438 6. Thompson RC, Lymbery AJ, Constantine cc. Variations in echinococcus: towards a taxonomic revision of genus. Adv Parasitol 1995; 145-76 7. Khuroo MS. Hydatid disease: current status and recent advances Ann Saudi Med 2002; 22: 56-64 8. Xiao N, Qiu J, Nakao M, et al. Echinococcosis Shiquicus M. Sp A taenid cestode from Tibetan fox and pateau Pika in china. Int J.Parasitol. 2005; 35: 693-701 9. Nait Silmane N, Taieb M, Khiali R, Rabehi H, Bekhouche R and Bendjaballah. A huge primary hydatid cyst of uterus: A case report. Journal of universal Surgery 2018; vol.6, No.2: 2254-55 10. Sehitogullari A. Our results in surgical treatment in hydatid cysts of lungs. Eur J Gen Med 2007 ;4(1) 11. Anyfantakis D, Bievrakis E, Viachakisi. Hepatopulmonary hydatidosis in a ten year old girl: A case report. J Med Case Rep 2010; 4 : 200 12. Romero Torres R, Campbell JR. An interpretive review of the surgical treatment of hydatid disease. Surg Gynecol Obstet. 1965; 121 : 851- 64 13. Men S, Hekimoglu B, YucesoyC, Arda IS, Baran L. Percutaneous treatment of hepatic hydatid cysts : An alternative to surgery, Am J Roentgenol. 1999; 172: 83-89 14. Bickel A, Daud G, Urbach D, Laparoscopic approach to Hydatid liver cyst: is it logical? Physical experimental and practical aspects. Surg. Endosc. 1998; 12:1073-74. 15. Gharaibeh KIA. Laparoscopic excision of splenic hydatid cyst. Postgrad Med J 2001; 77: 195-196. 16. Venukumar R. Clinical presentation of hydatid cyst of liver: descriptive study. Int Surg J.2017 Jan; 4(1): 214-16 17. Kir A, Baran E: Simultaneous operation for hydatid cyst of right lung and liver. Thorac Cardiovasc Surgeon. 1995, 43: 62-64. 10.1055/s- 2007-1013772 18. Ahmet A Balik, MD; Mahmut Basoglu MD; Fehmi Celebi et al.Surgical treatment of Hydatid disease of Liver. ARCH SURG/ vol.134, Feb1999. 19. Xynos E, Pechilvanides G, Tzortzinis A, Papageorgiou A, Vassilakis J. Hydatid disease of liver. Diagnosis and Surgical treatment. HPB Surgery. 1991; 4(1): 59-67.