Surgical Management and Outcomes of Hepatic Hydatid Cysts: A Clinical Analysis
Harsh Patel
Department of General Surgery, Dr. M K Shah Medical College and Research Centre, Ahmedabad, Gujarat, India.
Kalpit Piludaria *
Department of General Surgery, Dr. M K Shah Medical College and Research Centre, Ahmedabad, Gujarat, India.
Devarshi Bhagora
Department of General Surgery, Dr. M K Shah Medical College and Research Centre, Ahmedabad, Gujarat, India.
Priyank Menant
Department of General Surgery, Dr. M K Shah Medical College and Research Centre, Ahmedabad, Gujarat, India.
Gunvant Rathod
Department of General Surgery, Dr. M K Shah Medical College and Research Centre, Ahmedabad, Gujarat, India.
Bhavin Kothari
Department of General Surgery, Dr. M K Shah Medical College and Research Centre, Ahmedabad, Gujarat, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Hepatic hydatid disease, caused by the larval stage of Echinococcus granulosu, is a parasitic infection primarily affecting the liver and lungs. Surgical management remains the primary treatment for hepatic hydatid cysts, particularly for larger or complicated cases. This study aims to analyze the outcomes, complications, and recurrence rates associated with surgical intervention in hepatic hydatid cysts.
Methods: A retrospective review was undertaken involving ten patients who received surgical intervention for hepatic hydatid cysts at Dr. MK Shah Medical College and Research Centre in collaboration with Smt. SMS Multispeciality Hospital, Ahmedabad, from November 2022 to December 2024. Data were collected on cyst characteristics, surgical approach, postoperative complications, hospital stay, and recurrence rates. Surgical techniques included laparoscopic and open approaches, with procedures such as partial and total pericystectomy. Statistical evaluation was carried out using chi-square and Student’s t-tests.
Results: The cohort had a mean age of 32.7 years (range-19 to 55 years). The right hepatic lobe, particularly segments VII and VIII, was the most frequent site of cyst localization (7 patients). Laparoscopic surgery was performed in 6 cases, while 4 underwent open surgery. The most frequent postoperative complications included bile leak (4 cases) and surgical site infections (3 cases). Average hospital stay was 16.9 days, with a range between 10 and 25 days. The recurrence rate was 40%, with 4 cases showing cyst recurrence, particularly in patients who previously underwent laparoscopic partial pericystectomy. Statistical analysis showed no significant correlation between cyst size and surgical approach or hospital stay.
Conclusion: Laparoscopic surgery is a viable option for hepatic hydatid cyst management, offering advantages such as reduced morbidity and improved recovery. However, open surgery remains essential for complex or recurrent cases. Bile leaks and surgical site infections are the most common postoperative complications, requiring careful management. Recurrence remains a concern, particularly with partial pericystectomy, highlighting the need for long-term follow-up.
Keywords: Hydatid cyst, Echinococcus granulosus, hepatic hydatid disease, laparoscopic surgery, open surgery, recurrence, postoperative complications