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Mansy et al. Mini-invasive Surg 2018;2:36 I http://dx.doi.org/10.20517/2574-1225.2018.48 Page 5 of 9

Table 1. Characters of the hepatic hydatid cyst
Characters Number
Type
Clear 29 (38.16% )
Multivesicular 74 (71.84%)
Size
≤ 6 cm 22 (21.36%)
7-10 cm 62 (60.19%)
11-20 cm 15 (14.56%)
> 20 cm 4 (3.89%)

Cyst number
One cyst 74 (71.84%)
Two cysts 19 (18.44%)
More than 2 cysts 10 (9.72%)
Associations 14 (13.59%)
CBD 2 (1.94%)
Spleen 10 (9.71%)
Peritoneum 2 (1.94%)
Location
RT lobe 69 (66.99%)
Whole 4 (3.88%)
RT. Post Seg. VI, VII 17 (16.5%)
RT. Ant Seg. V, VIII 6 (5.82%)
Segment V 8 (7.77%)
Segment VI 18 (17.48%)
Segment VII 9 (8.74%)
Segment VIII 7 (7.8%)
LT lobe 21 (20.39%)
LT Lat. Seg. II, III 16 (15.53%)
Segment IV 5 (4.86%)
Central liver
Segment IV, V, VIII 4 (3.88%)
Bilobar 9 (8.74%)
Site
Superficial 27 (26.21%)
Vasculo-biliary cyst 76 (73.79%)
Non-complicated 73 (70.87%)
Complicated cysts before surgery 30 (29.13%)
Rupture 3 (2.91%)
Infection 12 (11.65%)
Recurrence 15 (14.56%)
Complicated cysts After US guided drainage 7 (6.8%)
Complicated cysts After endo-cystectomy 8 (7.76%)

Eight patients developed right sided pleural effusion, managed by albumin and diuretics. Four patients
developed ascites due to liver cirrhosis and portal hypertension were also managed by albumin and
diuretics. We faced wound infection in 5 patients. While incisional hernia in 3 patients developed 1 year
after surgery [Table 3].

DISCUSSION
[7]
Hydatid disease increased in sheep raising areas . The increased number of people immigrated from
contaminated areas as Iraq and Syria because of war as well as dogs in the street and contamination of
vegetables with dogs’ excreta, enhance the incidence of hydatid disease in our country lately.

[8]
The hydatid cyst presentation is always asymptomatic for many years, as it enlarges slowly . In our series,
38 (36.89%) patients were asymptomatic at the time of diagnosis. Symptoms arise either from pressure
effects on adjacent organs or when a complication occurs . The sensitivity of US in liver hydatid disease
[9]
[10]
diagnosis was 100%. Affection of liver lobes by Hydatid disease was more in the right lobe , which was
matching with our patients 69 (66.99%). The cysts are more commonly solitary as was the case in 74 (71.84%)
of our patients.