Is it essential to use scolicidal agent in open surgery for hepatic hydatid cyst ?

Abstract EN

Background and objective: Hydatid disease of the liver is endemic in Iraq and is a common health problem.

Although various treatment options have been described with injection of scolicidal agent into cyst cavity to reduce the recurrence but with risk of complication of such agents.

The aim was to assess the open surgical procedure in treatment of hepatic hydatid cyst without injection of scolicidal agents in terms of complication and recurrence rate.

Patients and methods: A prospective study of 103 patients with hepatic hydatid cyst operated upon by one consultant surgeon using open surgical approach during the period of 15 years (Feb 2000- March 2014) without intraoperative injection of scolicidal agent into the cyst cavity .

Results: The mean age was 33.1.(4–70 years).

Sex 35 males, 68 females.

M/F 1/1.9.

The size of the cyst was variable from 5-17cm in diameter.

Number of the cyst per patient was from 1-12 cysts.

Location of the cyst was 81 in the right lobe and 12 patients in the left lobe R/L 6.7/1.

Both lobes were involved in 10 patients.

Uncomplicated cyst in 67 patients and complicated in 36 patients.

Frank rupture into biliary system presented as cholangitis with jaundice was detected in 5 patients and intraperitoneal rupture was seen in one patient presented as acute abdomen with urticaria following blunt trauma .

Post operative morbidity was observed in 58 patients (56.3%) which include chest infection in 10 patients, wound infection in 10 patients, bile leak in 25 patients, hepatic abscess in 3 patients and recurrence rate detected in 10 patients (9.7%) Conclusion: As scolicidal agents are not free from complications (both local and systemic), dealing with hepatic hydatid cysts surgically without using scolicidal agents does not affect the recurrence rate