Surgical treatment of liver hydatid cysts
Surgical treatment of liver hydatid cysts is performed to remove hydatid cysts in a safe and effective way.
Some facts about Surgical treatment of liver hydatid cysts:
- Surgical treatment of hydatid cysts of the liver depends on communication of the cyst and the bile duct.
- Total cystectomy or hepatic resection is recommended if the cyst is localized peripherally because of the low rate of recurrence.
- Liver hydatid cysts should be treated once it is diagnosed because the cysts usually grow and cause complications.
- Infection, rupture into the peritoneal cavity, compression of or communication with the biliary tree, anaphylaxis, and secondary hydatidosis are the main complications.
- The parasite can be eliminated and recurrence of the disease can be prevented with minimum morbidity and mortality with appropriate treatment.
Preparation for Surgical treatment of liver hydatid cysts:
- Avoid eating and drinking anything at least four hours before your surgery.
- You may drink a sip of water with your medications if needed.
- Any history of bleeding disorders or are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting should be informed to your healthcare provider as you may be asked to stop taking these medicines before your surgery.
- The possible complications and side effects, the risks, and what the operation involves will be discussed with you by your doctor.
Procedure for Surgical treatment of liver hydatid cysts:
- The treatment of liver hydatid cysts depends on the cyst size, stage, localization, and relation to the bile ducts.
- Evacuation and obliteration of the cystic cavity is the aim of surgical intervention.
- ERCP or MRCP can be used for the appropriate surgical method in patients with suspected communication with the biliary system
- Surgery is the first option for type III cysts, type IV cysts, and cysts opening into the bile ducts or peritoneal cavity.
- The introflexion method is a simple, safe, and effective means of closing the cystic cavity in which the outer surface layers of the cyst is sutured to each other or to the bottom of the cavity to keep the cyst walls folded.
- Pericystectomy and hepatectomy are preferred in superficial and exophytic hydatid cysts and in cysts originating from Echinococcus alveolaris.
- Patient should be assessed for main bile duct contamination who have jaundice or a history of cholangitis, elevated liver enzymes, and dilatation or debris in major bile ducts.
- It is not necessary to perform main duct exploration if the bile ducts are evaluated with ERCP before surgery.
- Hydatid cysts that are lying around the hilus of the liver has a higher biliary communication rate than peripherally located cysts.
- The mortality and morbidity rates can be reduced by choledocoduodenostomy compared with the use of a T-tube for drainage.
- Partial or total cystectomy can be performed laparoscopically using an umbrella trocar which enables the surgeon to evaluate the cystic cavity to clip and suture the sites of bile duct leakage.
- Usually, a drain is placed to prevent abscess, biloma, or biliary peritonitis.
- It should be considered as a biliary fistula if bile drainage lasts for more than 10 days.
