Surgical treatment of complicated hepatic hydatic cyst

Hydatidosis is a parasitic disease considered benign but can become dangerous because of its complications. It is a real public health problem in the world by its frequency, morbidity, and its potential mortality. This work is a retrospective study, which was carried out on 15 patients with hydatid cyst of the liver complicated, admitted between 2012 and 2015 at the department of general surgery of the military Hospital Avicenne. The aim of this study is to report the epidemiological, diagnostic features and therapeutic management. The results of the epidemiological study showed that the hydatid cyst of the liver affects young adults with an average age of 38,5 years and a clear male predominance. The complicated form represents 15% of cases. The clinical expression was dominated by the right upper quadrant pain (80%) and fever (70 %). The most common complication was represented by fistula in the bile ducts found in 60% of cases. Ultrasound is the main paraclinical examination that allows the diagnosis. Cysts were type III in 70 % of cases, localized in the right lobe in 80 % of cases. Surgical treatment is performed in all cases. Medical therapy was used in 2 cases in association with surgery. Laparotomy was performed for all patients. Conservative procedure, which is the resection of the bulging dome, was used in all cases excepted for one patient who had a liver hydatid cyst in central location, who was treated by a trans-fistulo-oddian internal drainage. The average length of hospitalization was 17 days. Our results were satisfying with weak rate of morbidity (30%) and no recurrence. Prophylaxis is the best treatment in endemic areas.