Surgical Procedure Choice for Removing Hepatic Cysts of Echinococcus granulosus in Children

Abstract

Aim This study aims to evaluate the effectiveness of radical and conservative surgical procedures for removal of hydatid cysts in the liver of children.

Methods A total of 112 pediatric patients had surgical treatment of hepatic cystic echinococcosis (CE) between January 2002 and December 2012 at the First Affiliated Hospital of Xinjiang Medical University were retrospectively evaluated. The patients were divided into two groups receiving either radical (n = 26) or conservative surgery (CS) (n = 86). Patient age, gender, symptoms, preoperative radiologic investigations, type of cyst, involvement of other organs, surgical procedure performed, postoperative complications, and mean hospital stay after surgery were recorded.

Results The mean surgical procedure time for radical surgery (RS) was significantly longer than CS (126.4 ± 37 vs. 90.4 ± 22.9 minutes, p < 0.001], and the days for hospitalization showed no difference (11.0 ± 2.1 vs. 11.5 ± 3.1 days, p > 0.05]. Seven patients in the CS group had 20–300 mL of bile drainage 2–4 days post-operation and two patients developed a postoperative cavitary abscess; five patients in the RS group and one patient in the CS group developed a hydrothorax on the fifth day postoperatively. Follow-up of all patients showed that the majority had recovered well except for 3 cases who developed recurrences due to cysts ruptured accidently before surgery. There were no recurrences or biliary complications in the RS group.

Conclusion CS is an effective method for liver CE cyst removal and RS is suitable for hepatic cysts in less risk position in pediatric patients.

Keywords

Echinococcus granulosus - hepatic cystic echinococcosis - radical surgery - conservative surgery - liver - children

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