Background:-
Several techniques has been described in liver hydated disease surgery, with most well known conventional and radical procedures.Both are under debate.
Aim of the study:-
Is evaluation of the results of different surgical procedures for treatment of hydated cysts of the liver
Patients and Methods:-
Between January 1999 and January2005, 16 patients with cystic hydated diseases of the liver were managed in Sohag University Hospital, South Valley University.Diagnosis was made by both serological tests and imaging studies.Operative Procedures included the conventional partial cystectomy wit either omentoplasty or tube drainage in 9 cases, partial cystectomy with modified capitonage in 4 and radical procedures in 3.Complications were classified as minor or major according to their need of extrahospital stay. Main follow up was 20.6 months.
Results:-
Post operative complication rate was significantly better in patients with partial cystectomy with modifeied capitonage, than the other techniques (25% versus 58.3 % respectively, P <0 .05). The overall mortality rate was 6.2 %(1/16). Five patients (31.7%) had remained elevation of the total levels of serum IgG. Of those , 2 (12.5% ) patients Showed radiologically confirmed recurrence.
Conclusion:-
Partial cystectomy with modified capitonage in obliteration of the cyst cavity is easy to perform, quick and safe procedures wit satisfactory results provided that the hydatid cyst is in favourable anatomical location.
The conventional procedures are associated significantly with an increased treatment failure with respect to the complications and recurrence rate. Radical procedures are effective in complete erradication of the disease but has significantly higher rate of complications. Serological tests, using ELISA is considered in both follow up of patients and preoperative diagnosis of equifocal cases.