Open Conservative Surgical Management of Cystic Echinococcosis in a Tertiary Care Hospital, Nepal.

BACKGROUND

Cystic echinococcosis (CE) or hydatid disease caused by E. granulosus in Nepal is amenable to surgical treatment.

AIM: Aim of the study is to evaluate the efficacy of surgical treatment of CE, by open partial pericystectomy with albendazole as adjuvant.

MATERIALS AND

METHODS

Material of this prospective study were the consecutive series of 33 patients operated for CE, over a period of 8 years, at a single centre. Clinical examination, ultrasonography (USG) and computed tomography (CT) were used for establishing diagnosis. Patients were prescribed perioperative albendazole. Povidone iodine 10% (betadine)was used as contact scolicidal agent during operation. Cysts were evacuated from livers, lungs, retroperitoneum by partial pericystectomy. CE of mesentery was completely excised. Descriptive statistics was obtained using EPI- info windows version soft ware.

RESULTS

A total of 33 patients were operated for CE; 24 were females and 9 males. Age ranged from 4 years to 80 years. Organs/ site involved were: liver - 24, lungs - 4, combined liver and lungs - 2, retroperitoneum - 2 and mesentery - 1. Complication - bile leak for 2 weeks in an operated CE of liver. There was no mortality. Hospital stay (in days) was - mean 14 (range 7to21). Follow up for 3 years (average 2years) showed no recurrence.

CONCLUSION

Evacuation of CE by partial pericystectomy is an effective, safe and simple procedure, and gives excellent cure rate with perioperative albendazole therapy.