[Hydatid cysts of the liver. Therapeutic and prognostic classification. 378 cases].

OBJECTIVES

We retrospectively examined our clinical data on hydatic cysts of the liver collected over the last 10 years in order to determine a classification which could be used to guide future therapeutic decisions.

METHODS

From 1982 to 1992, hydatic cysts of the liver were surgically removed in 378 patients (mean age 38 +/- 12 years). Echography had been performed in all patients. Other preoperative investigations included computerized tomodensitometry (n = 57) and arteriography of the caeliomesenteric arteries (n = 12). Histological examination of surgical specimens included research for parasite inclusions within the pericyst and the hepatic parenchyma.

RESULTS

Single cysts were found in 65.7% of the cases, double cysts in 20% and multiple cysts in 12.5%. Histology revealed parasites in the pericyst in 129 cases (34%) and a fistula from the cyst to the bile duct was observed in 47 cases (12.5%). A classification was obtained based on 5 criteria: localization and number of cysts, cyst content, morphology of the pericyst and biliary-cyst fistula.

CONCLUSION

The excellent correlation between this classification and prognosis provides a valuable tool for the management of hepatic hydatic cysts.