Surgery for Hydatid Cyst of Liver

Surgery is often the primary treatment for hydatid cysts of the liver, which are caused by infection with the parasitic tapeworm Echinococcus granulosus. Hydatid cysts can cause symptoms such as abdominal pain, nausea, vomiting, jaundice, and fever, and if left untreated, they can lead to complications such as cyst rupture, infection, and obstruction of nearby organs.

The surgical approach to treating hydatid cysts of the liver depends on several factors, including the size, location, and number of cysts, as well as the overall health of the patient. Here are some common surgical options for hydatid cysts of the liver:

• Cystectomy: In cases where the hydatid cyst is small and located in a favorable position within the liver, a cystectomy may be performed. During a cystectomy, the surgeon removes the entire cyst while preserving as much healthy liver tissue as possible.
• Partial Hepatectomy: If the hydatid cyst is large or located near the surface of the liver, a partial hepatectomy may be necessary. This involves removing a portion of the liver containing the cyst while preserving the remaining liver tissue. The extent of liver resection depends on the size and location of the cyst.
• Percutaneous Aspiration, Injection, and Reaspiration (PAIR): In some cases, particularly for cysts that are difficult to access surgically or for patients who are not suitable candidates for surgery, a minimally invasive procedure known as PAIR may be performed. During PAIR, the cyst is punctured using a needle, and the fluid is aspirated. Then, a scolicidal agent (a substance that kills the parasitic larvae) is injected into the cyst, followed by reaspiration of the fluid. PAIR is often used as an adjunct to surgery or as a primary treatment for small cysts.
• Hydatid Cystectomy with Omentoplasty: In cases where the hydatid cyst has ruptured or is densely adherent to surrounding tissues, a more extensive surgical procedure known as cystectomy with omentoplasty may be necessary. This involves removing the entire cyst along with surrounding tissue, followed by the placement of a flap of omentum (a fold of tissue from the lining of the abdomen) over the residual cavity to prevent recurrence and promote healing.
• Laparoscopic Surgery: In select cases, laparoscopic or minimally invasive surgical techniques may be used to remove hydatid cysts of the liver. These procedures involve making small incisions in the abdomen and using specialized instruments and a camera to visualize and remove the cysts. Laparoscopic surgery may offer benefits such as shorter hospital stays, faster recovery, and reduced postoperative pain compared to traditional open surgery.