Radical versus conservative surgical management for liver hydatid cysts: A single-center prospective cohort study

Zhassulan Baimakhanov; Shokan Kaniyev; Erbol Serikuly; Maxat Doskhanov; Baglan Askeyev; Dinara Baiguissova; Aidar Skakbayev; Chingiz Sadykov; Raikhan Barlybay; Manas Seisembayev; Bolatbek Baimakhanov

doi:10.1002/jgh3.12649

Radical versus conservative surgical management for liver hydatid cysts: A single-center prospective cohort study

JGH Open. 2021 Aug 26;5(10):1179-1182. doi: 10.1002/jgh3.12649. eCollection 2021 Oct.

Affiliations

¹ Department of HPB Surgery and Liver Transplantation Syzganov's National Scientific Center of Surgery Almaty Kazakhstan.
² Department of Radiology Syzganov's National Scientific Center of Surgery Almaty Kazakhstan.

Abstract

Background and aim: We prospectively compared the clinical outcomes of radical and conservative surgical procedures for primary liver hydatid cysts, additionally radical surgical procedures with and without the two-month administration of albendazole after the operation were compared.

Methods: Overall, 90 patients undergoing open surgical treatment for liver hydatid cysts were divided into three surgical groups: first group, patients who underwent radical surgery (pericystectomy) followed by albendazole treatment for 2 months following the operation group; second group, patients who underwent radical surgery(pericystectomy) without receiving albendazole after surgery group; third group, patients, who underwent conservative surgery (partial cystectomy) with albendazole treatment after surgery. The clinical outcomes and rate of recurrence were analyzed in follow-up period.

Results: The mean surgery duration in the Radical groups was significantly longer in comparison to the Conservative surgery + Albendazole group. (212.0 and 202.5 min vs. 173.2 min; p < 0.05). Blood loss in the Radical groups was significantly higher in comparison to the Conservative surgery + Albendazole group (218.3 and 174.6 ml vs. 67.2 ml; p < 0.05). However, postoperative complication rate in the Radical group was significantly lower in comparison to Conservative surgery + Albendazole group (13.3% [n = 4] and 6.7% [n = 2] vs. 36% [n = 11]; p < 0.05). The postoperative hospital stay in both Radical groups was significantly lower in comparison to the Conservative surgery + Albendazole group (7.9 and 7.4 days vs. 11.3 days; p < 0.05).

Conclusion: In comparison to conservative surgery, radical surgery is a preferable treatment modality for patients with active liver hydatid cysts. Postoperative albendazole treatment is preferable, regardless of the type of surgical procedure.

Keywords: albendazole; hepatic echinococcosis; hydatid cyst; postoperative complications; recurrence.