19-Year Retrospective Analysis of 146 Surgically Managed Hepatic Hydatid Cysts: Complications Across Four Procedure-Based Groups.

BACKGROUND

Cystic echinococcosis remains endemic in many regions, with the liver representing the most affected organ. Surgical treatment is still required for large, symptomatic, or complicated hepatic hydatid cysts.

OBJECTIVE

To evaluate surgical outcomes and postoperative complications associated with different surgical approaches for hepatic hydatid cysts in a single-centre cohort over 19 years.

METHODS

This retrospective observational study included 146 patients who underwent surgical treatment for hepatic hydatid cysts at Mureș Clinical County Hospital between 2004 and 2023. Patients were classified into four groups according to the surgical technique: open conservative surgery (Mabit-Lagrot, with or without Kehr drainage), minimally invasive procedures (PAIR/PAIR-D), radical or complex surgery, and ultrasound-guided drainage. Demographic, operative, and postoperative outcomes were analysed.

RESULTS

The Mabit-Lagrot technique was the most frequently performed procedure (45.9%). Overall, postoperative complications occurred in 25.3% of patients, with recurrent abscessed hydatid cysts representing the most common event. Minimally invasive procedures were associated with shorter hospital stays and lower complication rates in selected cases. Postoperative total bilirubin and amylase levels differed significantly across surgical groups, with higher values observed after more invasive procedures.

CONCLUSION

Postoperative outcomes following surgical treatment of hepatic hydatid cysts vary according to procedural invasiveness. While open surgery remains effective, it is associated with higher morbidity. Minimally invasive approaches represent valid alternatives in appropriately selected patients. Early postoperative bilirubin and amylase levels appear to reflect surgical invasiveness rather than predict complications.