Diagnosis and surgical treatment of complicated liver echinococcosis.

Background/aims: Complicated liver echinococcosis considerably worsens the prognosis of the disease. In this study the treatment of patients with complicated disease was analyzed.

Methods: The records of 136 patients who had undergone surgery in our clinic during the last decade were evaluated.

Results: Among all complications, the most common were lesions of the bile ducts (88 patients) and suppuration of the cysts (77 patients). Twenty-nine cases had a combination of two complications. Surgery was based on the nature of complications, number and sizes of hydatid cysts and patients general condition. The surgical treatment of choice was echinococcectomy, with possible liquidation of the fibrous capsule cavity. In cases with complications such as suppuration, remaining bile fistulas, large cyst cavities or extrahepatic location, external drainage is obligatory. Post-operative complications occurred in 43 patients (31.6 %), 22.4 % of them being specific in nature. Postoperative mortality was 2.2 % (three patients).

Conclusion: Timely diagnosis, appropriate investigation and well planned surgical techniques may improve the outcome of complicated liver echinococcosis.