Percutaneous drainage as a first therapeutic step prior to surgery in liver hydatid cyst abscess: Is it worth it?

Table 1 Clinical debut, analysis, diagnostic methods, surgery, morbidity and follow-up of our cases

	Case 1	Case 2	Case 3
Sex	Male	Female	Female
Age (yr)	80	75	55
Age	80	75	55
Clinic	Fever, dyspnoea and malaise last 15 d duration Poor general condition	Fever and malaise for several days Poor general condition	High fever (> 39 °C) accompanied by discomfort in right hypochondrium Poor general condition
Analytics	18610 leukocytes, 90.8% neutrophils, Hgb 8.4 g/dL INR 1.13, Cr 0.75 mg/dL, GGT 433 U/L, AST 35 U/L	24610 leukocytes (95% neutrophils), Hgb 10.9 g/dL, INR 1.24, Cr 1.56 mg/dL, PCR 315 mg/L, GGT 70 U/L and AST 47 U/L	18666 leukocytes, 84.8% neutrophils, Hgb 10.6 g/dL, INR 1.14, PCR 19.4 mg/dL, GGT 270 U/L, AST 379 U/L
Radiography/ultrasound	A right liver lesion with calcified wall and echoes inside, probably detritus, compatible with LHA	-	An abdominal mass with fluid level in right hypocondrium was seen
Abdominal CT	An abdominal mass with fluid level in right hypochondrium	A 12 cm abscess in the liver compatible with LHA	An 11.5 cm liver mass located in segments VI and VII with fluid level, communicating with bile duct and causing inferior vena cava compression
Size	13 cm	12 cm	11.5 cm
Culture	Klebsiella pneumoniae	Streptococcus viridans	Streptococcus salivarius
Time from pair to surgery	16 d	12 d	15 d
Surgery	Subtotal cystectomy cholecystectomy, bile duct exploration, closure of small cystobiliary communications and omentoplasty	Subtotal cystectomy, cholecystectomy and bile duct clearance	Subtotal cystectomy and bile duct clearance
Morbidity	Atelectasis and pleural effusion, fungaemia (Candida Albicans) and transfusion	No	Red blood cell transfusion
Postsurgical stay	34 d	5 d	4 d
Total stay	50 d	17 d	19 d
Follow-up	No recurrence	No recurrence	No recurrence
	14 mo	6 yr	2.5 yr

CT: Computed tomography; LHA: Liver hydatid abscess; PCR: Polymerase chain reaction.