Radical vs conservative surgery for hydatid liver cysts: Experience from single center

Table 1 Comparison of both groups according to Gharbi classification

Type of cyst	Gharbi classification	Radical surgery	Conservative surgery	Total
Type I	Pure fluid collection	Excluded		0
Type II	Fluid collection with a split wall	2	7	9
Type III	Fluid collection with septal	5	14	19
Type IV	Heterogenous acho pattern	4	8	12
Type V	Reflecting thick walls	Excluded		0
Type III-IV		4	7	11
Type III-IV-V		3	5	8

Table 2 Comparison of surgical characteristics, follow-up time and postoperative complications among the both groups n (%)

Surgical features	Radical surgery	Conservative surgery	Total	P
Number of patients	18 (30.5)	41 (69.5)	59 (100)
Operation time (min)	83.25 ± 12.09	51.97 ± 15.07	60.91 ± 19.92	< 0.001
Hospitalization time (d)	7.62 ± 1.49 (5-10)	7.24 ± 1.86 (4-21)	7.42 ± 1.69	NS
Cyst count	1.72 ± 1.0 (1-4)	1.99 ± 1.33 (1-6)	1.86 ± 1.24	NS
Cyst size (cm)	16.27 ± 7.1 (8-32)	12.98 ± 4.9 (6-26)	13.98 ± 5.83	NS
Location				NS
Right	9 (50.0)	23 (56.1)	32 (54.2)
Left	5 (27.8)	7 (17.1)	12 (20.4)
Bilateral	4 (22.2)	11 (26.8)	15 (25.4)
Postoperative complication				NS
Biliary leakage	2 (11.1)	3 (7.3)	5 (8.5)
Atelectasis	1 (5.5)	1 (2.4)	2 (3.3)
Bilioma	0	1 (2.4)	1 (1.6)
Pneumonia	0	2 (4.8)	2 (3.3)
Wound infection	0	3 (7.3)	3 (5.0)
Surgical procedures				NS
Pericystectomy	14 (77.7)	0	14 (23.7)
Segmentectomy	4 (22.3)	0	4 (6.8)
PC + D + Om	0	36 (87.8)	36 (61)
PC + D	0	5 (12.2)	5 (8.5)
Scolocidal solution				NS
Saline	12 (66.7)	29 (70.7)	41 (69.5)
Betadine	6 (33.3)	12 (29.3)	18 (30.5)
Follow-up time (mo)	30.72 ± 17.92	30.29 ± 15.08	30.42 ± 15.71	NS
Recurrence disease	0	7 (17)	7 (11.8)	0.045

NS: Not significant.

Table 3 Comparison of both groups in terms of clinical and demographic characteristics n (%)

Demographic features	Radical surgery	Conservative surgery	Total	P
Number of patient	18 (30.5)	41 (69.5)	59 (100)	NS
Male	7 (38.9)	17 (41.5)	24 (40.6)
Female	11 (61.1)	24 (58.5)	35 (59.4)
Age (yr)	42.1 ± 13.87	43.5 ± 13.9	43.0 ± 13.77	NS
Distribution according to age				NS
< 40	6 (33.3)	17 (41.46)	23 (39.0)
40-60	9 (50.0)	19 (46.34)	28 (47.5)
> 60	3 (16.7)	5 (12.20)	8 (13.5)
Residence				NS
Village	9 (50.0)	26 (63.4)	35 (59.3)
Suburban	7 (38.9)	9 (22.0)	16 (27.1)
Urban	2 (11.1)	6 (14.6)	8 (13.6)
Occupation				NS
Housewife	7 (38.9)	21 (51.2)	28 (47.5)
Shepherd	4 (22.2)	7 (17.1)	11 (18.6)
Farmer	4 (22.2)	8 (19.5)	12 (20.3)
Student	1 (5.6)	3 (7.3)	4 (6.8)
Officer	2 (11.1)	2 (4.9)	4 (6.8)

Table 4 Postoperative complications and management

Complications	Radical surgery	Conservative surgery	Management
Bilioma	0	1	Percutaneous drainage (other center)
Wound infection	0	3	Secondary healing therapy
Atelectasis	1	1	PEEP
Pneumonia	0	2	PEEP + antibiotherapy
Biliary leakage	2	3	3 cases: ERCP + sphincterotomy
			1 case: ERCP + sphincterotomy + internal biliary stent
			1 case: choledoc exploration + T-tube drainage

PEEP: Positive end-expiratory pressure.