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Surgical approaches to hepatic hydatidosis 
ranging from partial cystectomy to liver transplantation 

Ann Hepatobiliary Pancreat Surg 2018 Aug;22(3):208-15
Published online August 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Sanjay Goja, Sujeet Kumar Saha, Sanjay Kumar Yadav, Anisha Tiwari, Arvinder Singh Soin

Institute of Liver Transplantation and Regenerative Medicine, Medanta The Medicity, Gurgaon, India
Received April 8, 2018; Revised June 14, 2018; Accepted June 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Backgrounds/Aims: A wide range of surgical approaches has been described for hepatic hydatidosis aiming primarily at the reduction of disease recurrence and minimization of postoperative morbidity. 
Methods: A database analysis of patients with liver hydatidosis who underwent different surgical procedures between March 2010 and May 2016 was performed. 
Results: A total of 21 patients with cystic echinococcosis (CE) and four cases of alveolar echinococcosis (AED) were detected. Nine patients manifested recurrent disease at presentation. Among CE cases, 5 underwent partial cystectomy (2 laparoscopic and 3 open), 9 cysto-pericystectomy (7 open and 2 robotic) and 7 hepatectomies (1 central, 4 right, 1 left and 1 right trisectionectomy). Living donor liver transplantation was performed in 3 patients with AED and the fourth patient underwent right trisectionectomy with en bloc resection of hepatic flexure and right diaphragm. Seven developed Clavien grade II and three grade III complications. The mean follow-up of CE was 34.19±19.75 months. One patient of laparoscopic partial cystectomy developed disease recurrence at 14 months. No recurrence was detected at a mean follow-up of 34±4.58 months following LDLT and at 24 months following multivisceral resection for AED. 
Conclusions: The whole spectrum of tailored surgical approaches ranging from minimally invasive to open and extended liver resections represents safe, effective and recurrence-free treatment of hepatic hydatidosis.
Keywords : Liver; Hydatid cyst; Robotic; Liver transplantation


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