Different scenarios and management of complicated hepatic cystic echinococcosis: a case series.

Cystic echinococcosis (CE) is a zoonotic illness that primarily affects the liver. Antiparasitic therapy remains the primary treatment method. Surgical intervention includes open and laparoscopic surgery, with a focus on preserving liver functionality. Data from complicated CE cases, confirmed surgically, were retrieved and presented. Six patients were included: two had a history of CE (one underwent puncture, aspiration, injection, re-aspiration [PAIR], and the other underwent right hemi-hepatectomy). Among the cases, two presented with obstructive jaundice, three had exophytic lesions, one had a large, calcified lesion, one exerted a mass effect on the intrahepatic inferior vena cava (IVC), one showed subcapsular extension, and the sixth case involved a large cyst that regressed with albendazole. In conclusion, although surgery remains the primary treatment for complicated hepatic CE, PAIR is preferred for uncomplicated cases. However, surgical challenges may be greater after PAIR.