Role of interventional radiology in the management of hepatic hydatid disease

Table 2 Comparison between radical and non-radical surgical procedures

	Radical surgery (closed method): Hepatic resection and total cystectomy	Non-radical conservative surgery (open method): Partial cystectomy
Ref.	Baimakhanov et al[17], 2021; Deo et al[18], 2020; Farhat et al[19], 2022; Akbulut et al[20], 2010; Stojkovic et al[21], 2016
What is resected	The entire parasitic larval cyst and the host-derived fibrous capsule are removed	The entire parasitic larval cyst and only a part of the host-derived fibrous capsule are removed
Difficulty of surgery	More challenging	Easier
Intraoperative opening of the cyst	Not opened, so lower risk of spillage and secondary hydatidosis	Opened, so risk of spillage and secondary hydatidosis
Perioperative albendazole prophylaxis	Can be theoretically stopped immediately after surgery	Essential to be continued after surgery
Long-term follow-up for secondary echinococcosis	Theoretically not required	Essential
Postoperative biliary leakage/bilioma	Less common	More common
Bleeding	More common	Less (as the host-derived posterior segment of the fibrous capsule that is intimately aligned with the liver is left in place)
Anatomically critical sites	Surgery may not be possible	May be performed (as the host-derived fibrous capsule is left untouched): e.g., HHC intimately attached to the main portal vein
HHC is in proximity to the liver capsule	Can be performed even if HHC is completely surrounded by liver parenchyma, and does not extend till the liver capsule	Only suitable for cysts where the host-derived fibrous capsule is extending to the surface of the liver (otherwise high risk of bleeding/hematogenous dissemination)

HHC: Hepatic hydatid cyst.