Surgical management of complicated hydatid cysts of the liver.

The most significant complications of hydatid cyst of the liver are rupture and suppuration with an incidence of 6-19%. Rupture into the biliary tract was the most frequent complication and comprised 170 out of 222 complicated hydatid cysts of the liver in the author's series. These jaundiced patients were managed both by obliteration of the residual cavity and restoration of the patency of the biliary tract which was obstructed by daughter cysts of remnants of the laminated membrane. Rupture into the bronchi requires immediate treatment due to bronchopulmonary complications which might ensue. Rupture into blood vessels and into the free peritoneal cavity is accompanied by severe anaphylactic shock which does not readily respond to corticosteroids. The former complication is accompanied by a high mortality rate, while the postoperative mortality of patients experiencing anaphylactic shock amounts to 1.8%.