2011, Number 4
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Cir Cir 2011; 79 (4)
Hydatid liver disease. Our 25-year experience
Cubas-Castillo R, Brain CO, López-Guillemain R, Ballarino EA
Language: Spanish
References: 33
Page: 331-337
PDF size: 471.32 Kb.
ABSTRACT
Background: Hydatid disease is a zoonosis caused by
Echinococcus spp., which inhabits the intestine of some canines (dog). Humans are accidental intermediate hosts and can accommodate one or more cysts in different locations, mainly the liver and lungs. The standard treatment of hydatid disease has historically been surgical, including conservative and radical procedures. Our area of influence is considered endemic.
Methods: We conducted a retrospective and descriptive study that included 57 patients diagnosed with hydatid liver disease who were treated surgically from January 1985 to December 2009.
Results: Females represented 50.9% of the subjects with a mean age of 53 years. The main clinical presentation was pain in 56% of patients and palpable mass in 33.3%. In 93% of cases we used ultrasonography as a diagnostic method (100% sensitivity). Erythrocyte sedimentation rate was increased in 63%. Total cystectomy was performed on 47.4% of patients. Surgical morbidity was 29.8%. Surgical mortality was zero. The average number of days of hospitalization was 12.
Conclusions: Clinical and epidemiological analysis is the mainstay of diagnosis, supplemented by ultrasound, CT scan and blood tests. We suggest total cystectomy as the first surgical choice when feasible due to its lower morbidity/mortality and shorter postoperative hospital stay, according to similar series.
REFERENCES
Moro P, Schantz PM. Echinococcosis: a review. Int J Infect Dis 2009;13:125-133.
Farreras P, Rozman C, eds. Medicina Interna. Tomo 2. Vigésima tercera edición. Madrid: Harcourt Brace; 1995. pp. 2472-2474.
Atias A, Neghme A. Parasitología clínica. Segunda edición. Buenos Aires: Intermédica; 1985. pp. 341-354.
Odriozola M, Pettinari C. Relato Oficial de Hidatidosis Abdominal, 691 Congreso Argentino De Cirugía. Rev Arg Cir 1998; número extraordinario: 5-70.
Golematis BC, Peveretos PJ. Hepatic hydatid disease: current surgical treatment. Mt Sinai J Med 1995;62:71-76.
Xu M. Progress in surgical treatment of hydatid disease in China. A clinical analysis of 22,005 surgical cases. Chin Med J Engl 1995;198:295-299.
Yagci G, Ustunsoz B, Kaymakcioglu N, Bozlar U, Gorgulu S, Simsek A, et al. Results of surgical, laparoscopic, and percutaneous treatment for hydatic disease of the liver: 10 years experience with 355 patients. World J Surg 2005; 29:1670-1679.
Stamatakos M, Sargedi C, Stefanaki Ch, Safioleas C, Matthaiopoulou I, Safioleas M. Antihelminthic treatment: an adjuvant therapeutic strategy against Echinococcus granulosus. Parasitol Int 2009;58:115-120.
Larrieu E, Frider B, del Carpio M, Salvitti JC, Mercapide C, Pereyra R, et al. Portadores asintomáticos de hidatidosis: epidemiología, diagnóstico y tratamiento. Rev Panam Salud Publica 2000;8:250-256.
Romero R. Tratado de Cirugía. México: Interamericana; 1988. pp. 371-416.
Capron A, Vernes A, Biguet J. Le diagnostic immunoélectrophorétique de l’ hydatidose. En: SIMEP, ed. Le Kyste Hydatique du Foie. Lyon, France: Journées Lyonnaises d ‘Hydatidologie; 1967. pp. 27-40.
Capron A, Yarzábal L, Vernes A, Fruit J. Le diagnostic immunologique de L’échinococcose humaine (bilan personnel à propos de 400 observations). Pathol Biol 1970;18:357-365.
Moreno-González E, Jover-Navalón JM, Landa-García JI, Moreno- Azcoíta M, Silecchia G, Gómez-Gutiérrez M, et al. Surgical management of liver hydatidosis. 10-year experience with 269 patients. Ital J Surg Sci 1985;15:267-273.
Maaouni A, Elalaoui M, Hamiani O, Benmansour A, Belkouchi A, Ahyoud F, et al. Surgery of hydatid cysts of the liver: 581 patients, 952 cysts. Chirurgie 1989;115(suppl 1):61-69.
Movchun AA, Timoshin AD, Zavenian ZS, Got’e SV, Abdullaev AG, Itin LS. Surgical treatment of polycystic disease of the liver. Khirurgiia 1991;Jan(1):83-89.
Aeberhard P, Fuhrimann R, Strahm P, Thommen A. Surgical treatment of hydatid disease of the liver: an experience from outside the endemic area. Hepatogastroenterology 1996;43:627-636.
Alfieri S, Doglietto GB, Pacelli F, Costamagna G, Carriero C, Mutignani M, et al. Radical surgery for liver hydatid disease: a study of 89 consecutive patients. Hepatogastroenterology 1997;44:496-500.
Correa-Tineo S, Culqui-Lévano C, Pinto-Paz M, Huillca L, Salinas-Alva E. Hidatidosis hepática: revisión de casos intervenidos quirúrgicamente en el Hospital Militar Central. Rev Gastroenterol Peru 2000; 20:270-284.
Manterola C, Vial M, Pineda V, Sanhueza A, Barroso M. Factors associated with morbidity in liver hydatid surgery. ANZ J Surg 2005;75:889-892.
Filip V, Niculescu D, Târcoveanu E, Dănilă N, Ene D, Popa P, et al. Hydatic cyst of the liver. Considerations on 337 cases. Rev Med Chir Soc Med Nat Iasi 2005;109:294-299.
Avgerinos ED, Pavlakis E, Stathoulopoulos A, Manoukas E, Skarpas G, Tsatsoulis P. Clinical presentations and surgical management of liver hydatidosis: our 20 year experience. HPB 2006;8:189-193.
Ezer A, Nursal TZ, Moray G, Yildirim S, Karakayali F, Noyan T, et al. Surgical treatment of liver hydatid cysts. HPB 2006;8:38-42.
Krasniqi A, Hoxha FT, Nuhiu B, Bicaj B, Bruqi B, Tanaj H, et al. Results of different surgical methods in management of hepatic hydatidosis. Med Arh 2006;60(6 suppl 1):23-25.
Daradkeh S, El-Muhtaseb H, Farah G, Sroujieh AS, Abu-Khalaf M. Predictors of morbidity and mortality in the surgical management of hydatid cyst of the liver. Langenbecks Arch Surg 2007;392:35-39.
Agayev RM, Agayev BA. Hepatic hydatid disease: surgical experience over 15 years. Hepatogastroenterology 2008;55:1373-1379.
Secchi MA, Pettinari R, Mercapide C, Bracco R, Castilla C, Cassone E, et al. Surgical management of liver hydatidosis: a multicentre series of 1412 patients. Liver Int 2010;30:85-93.
Polat P, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A. Hydatid disease from head to toe. Radiographics 2003;23:475-494.
Sánchez-Ruano JJ, Gil-Grande LA, Martínez-Potenciano JL. Quistes hidatídicos hepáticos: tratamiento médico, seguimiento ecográfico. Rev Esp Ecografía Digestiva 2000;2:9-18.
Ahmet A, Mahumut B, Fehivi C, Durkaya O. Surgical treatment of hydatid disease of liver. Review of 304 cases. Arch Surg 1999;134:122-128.
Behrns KE, Van Heeden JA. Surgical management of hepatic hydatid disease. May Proc 1991;66:1193-1197.
World Health Organization. Manual on echinococcosis in humans and animals: a public health problem of global concern. Paris: World Organization for Animal Health and World Health Organization; 2001. pp. 20-69.
Filippou D, Tselepis D, Filippou G, Papadopoulos V. Advances in liver echinococcosis: diagnosis and treatment. Clin Gastroenterol Hepatol 2007;5:152-159.
Zinner M, JAshley S Jr. Maingots. Abdominal Operations. 10th ed. Stamford, CT, USA: McGraw-Hill; 1997. pp. 1434-1444.