PT  - JOURNAL ARTICLE
AU  - Guillaume Martel
AU  - Salima Ismail
AU  - André Bégin
AU  - Franck Vandenbroucke-Menu
AU  - Réal Lapointe
TI  - Surgical management of symptomatic hydatid liver disease: experience from a Western centre
AID  - 10.1503/cjs.024613
DP  - 2014 Oct 01
TA  - Canadian Journal of Surgery
PG  - 320--326
VI  - 57
IP  - 5
4099  - http://canjsurg.ca/content/57/5/320.short
4100  - http://canjsurg.ca/content/57/5/320.full
SO  - CAN J SURG2014 Oct 01; 57
AB  - Background Hydatid liver cysts are rare in North America. The objective of this study was to determine the optimal surgical management for hydatid liver cysts treated outside endemic areas.Methods We reviewed the cases of consecutive patients who underwent management of hydatid liver cysts. Radical liver resections were compared with other types of procedures. Clinical presentation, investigations, perioperative outcomes and long-term follow-up were evaluated. We evaluated disease recurrence using the Kaplan–Meier method.Results Forty patients underwent surgery for hydatid liver cysts. Most patients had single (68%) right-sided (46%) cysts with a median size of 10 cm. Most (83%) underwent liver resection with or without drainage/marsupialization. Radical liver resection was carried out in 60% (19 major, 5 minor). Additional procedures were required in 50% (biliary fistulization 30%, diaphragmatic fistulization 20% or paracaval location/ fusion 8%). Postoperative complications occurred in 48%. The median follow-up was 39 months. The 3-year recurrence-free survival was significantly different between patients who had radical resection and those who had other procedures (100% v. 71%, p = 0.002).Conclusion The surgical management of hydatid liver cysts in North America remains rare and challenging and is frequently associated with fistulizing complications. Excellent long-term outcomes are best achieved using principles of radical liver resection that are familiar to North American surgeons.