Surgical Alternatives Used in the Treatment of Liver Hydatid Cyst: A Systematized Approach Based on Evidence (an Overview)

Abstract

© 2016, Universidad de la Frontera. All rights reserved. Echinococcosis is an endemic zoonosis in the south of Chile; we therefore have occasion to treat a large number of patients, particularly in the liver. Hepatic echinococcosis (HE) has its own morbidity and mortality due to evolutionary complications, to which the risk of complications related to the surgical procedures is added, the morbidity which has been reported up to 80 %. This is associated with a history of previous surgeries for HE, evolutionary complications of the cyst, the need for additional procedures such as the treatment of the disease in other simultaneous locations, etc. Moreover, reported mortality is up to 10 %, a situation that remains unchanged despite technological and therapeutic advances. The surgical treatment of HE can be divided into four phases: isolation of the surgical area, evacuation of the cyst, treatment of the complications of the cyst and treatment of the residual cavity. HE surgical procedures can be classified as conservative (marsupialization, cystostomy, Posadas technique and cystojejunostomy) and radical (pericystectomy and hepatic resections). Finally, the role of laparoscopic surgery, which is still under evaluation, is also worthy of note. The aim of this article is to present a general evidence-based overview of some surgical aspects of interest in the treatment of HE. In this article issues of the different surgical options utilized for HE treatment and their results are discussed, based on published evidence.