The authors of the study emphasize that the choice of the best surgical intervention method remains a subject of active discussion. Previously, preference was given to organ-preserving surgeries; however, there has recently been a growing interest in radical treatment methods for hydatid echinococcosis.
The main objective of this study was to investigate both the immediate and long-term outcomes of organ-preserving and radical surgical methods.
The study involved 359 patients diagnosed with hydatid echinococcosis of the liver. Among them, 299 had primary echinococcosis (83.3%), while 60 had recurrent echinococcosis (16.7%). The gender distribution was fairly even: 176 men (49%) and 183 women (51%).
Organ-preserving surgeries were performed on 232 patients (64.4%). The postoperative mortality rate was 0.9% (2 cases). Complications after surgery were observed in 44 patients (18.9%), and recurrences of the disease were identified in 12 patients (5.2%). The most common complication was a residual cavity, recorded in 28 individuals (12.1%), of which 10 (4.3%) encountered a purulent process.
As for radical surgical intervention, it was performed on 127 patients, among whom fatalities were recorded in 2 individuals (1.6%). Postoperative complications occurred in 14 patients (11%), with hemorrhagic and biliary complications being the most frequent, observed in 9 patients. Intra-abdominal bleeding was registered in 5 individuals: in 4 cases, it was moderate and successfully managed with conservative treatment, while one patient required reoperation. Two cases of liver failure developed in patients after complex resections and were successfully managed with medication.
In conclusion, the authors of the study conclude that the radical removal of the fibrous capsule along with surrounding tissues (pericystectomy, liver resection) leads to more favorable immediate and long-term outcomes in the surgical treatment of hepatic echinococcosis.
