Page 293 - Read Online

Page 6 of 9 Mansy et al. Mini-invasive Surg 2018;2:36 I http://dx.doi.org/10.20517/2574-1225.2018.48

Table 2. Characters of recurrent cases managed by total pericystectomy
Demographic data Cyst characters
N
Age Sex Symptoms Co-morbidity No. Size Location Associations
Seven cases with past history of US guided drainage
1 55 M Abdominal pain HPN 3 Peritoneum > 20 cm Seg. II, III Peritoneum
Mass Spleen 8 cm × 7 cm Spleen
Liver 6 cm × 6 cm
2 22 F Abdominal pain Non 1 7 cm × 7 cm Seg. VIII Non
3 35 F Abdominal pain Non 1 8 cm × 8 cm Seg. V GB stones
Nausea & Vomiting
4 28 M Abdominal pain Liver cirrhosis 1 6 cm × 7 cm Seg. VI Non
HCV + ve
5 30 F Abdominal pain Non 1 8 cm × 8 cm Seg. II, III Non
6 35 F Abdominal pain Non 1 7 cm × 7 cm Seg. VII Non
7 48 F Abdominal pain Cardiac 2 6 cm × 7 cm Seg. III, III Non
Fever 3 cm × 3 cm
Eight cases with past history of endocystectomy
1 23 F Abdominal pain Non 1 7 cm × 8 cm Seg. VII Biliary Fistula
2 32 F Abdominal pain Non 1 7 cm × 6 cm Seg. VI Non
3 25 F Abdominal pain Non 1 8 cm × 8 cm Seg. VIII Non
Nausea & Vomiting
4 50 F Incisional hernia Non 3 RT 9 cm × 8 cm 2 RT Seg. VIII Past history of splenectomy
Abdominal pain 7 cm × 7 cm Seg. VI Right biliary cyst after
LT 6 cm × 5 cm 1 LT Seg.IV endocystectomy
5 45 M Abdominal pain DM 1 7 cm × 8 cm Seg. IV Non
6 28 F Abdominal pain Non 1 6 cm × 8 cm Seg. II, III GB stones
Nausea & Vomiting
7 27 F Abdominal pain Non 2 LT 6 cm × 6 cm LT Seg. IV Non
RT 7 cm × 8 cm RT Seg. VII
8 55 M Abdominal pain HCV + ve 1 8 cm × 9 cm Seg II, III Biliary Fistula

Table 3. Postoperative outcomes
Outcome Number
Hospital stay 7 days (5-10 days)
ICU stay 2 days (1-3 days) 18 (17.48%)
Operative time 170 min (120-250 min)
Blood loss 600 mL (300-2000 mL)
Blood transfusion 2-4 units 32 (31.07%)
Fresh frozen plasma 2-4 units 39 (37.86%)
Complications 1 21 (20.39%)
Bleeding 1 (0.97%)
Biliary leak 4 (3.88%)
Chest infection 4 (3.88%)
Pleural effusion 8 (7.76%)
Ascites 4 (3.88%)
Wound infection 5 (4.85%)
Burst abdomen 1 (0.97%)
Incisional hernia 3 (2.91%)
1
Patient had more than one complication

Assessment of cysto-biliary communication presence via preoperative detection was essential. Recurrent
episodes of cholangitis and Large cysts occupying several liver segments are highly suggestive of cysto-
[11]
biliary communications, and a search for the fistula should be meticulous . In our series MRCP was
mandatory for all patients for detection of cysto-biliary communications.

Since effective anti-parasitic medical treatment has not yet proved to treat and to effectively cure the
[12]
disease, the optimal treatment for hepatic hydatid cyst is surgery . Treatment of hepatic hydatid cyst