Feasibility of radical surgery in hepatic hydatidosis in a center with intention of radical surgery

Background: Echinococcosis is a zoonosis, still endemic in some geographical areas, like Spain, with no official data since 1996. The most frequent location is the liver and lungs. Treatment depends on the number, location and size of the lesions and on the patient’s symptoms. If it is possible, radical surgery is gold standard. Our objective is to determine the percentage of radical surgery in our center and analyze the Results according to radical or non-radical surgery. Material & Method: A prospective observational study of patients with surgery for hepatic hydatid disease was performed (May 2007-December 2017). Surgical indication was established in all active hydatid cysts CE1 to CE3 and in any complicated cyst (CE1-CE5). We excluded patients who underwent urgent surgery, not considered suitable for surgery and refused surgery. The patients were classified into radical (open and laparoscopic total cystectomy, liver resection) or non-radical surgery (any other than the total cystectomy, Lagrot). All the interventions were carried out with the intention of performing radical surgery in all cases. Age, sex, symptoms, location, size, ERCP or percutaneous drainage (PD) performance, complications, length of stay (LOS) and recurrence were collected. Results: Seventy-one patients and 90 hydatid cysts were included. The data are shown in Table 1. We performed radical surgery in 70.42% patients and 67.78% cysts. Non-radical surgery was associated with a higher major complications and LOS, with similar biliary leakage. Conclusion: The trend in hydatidosis is to perform radical surgery. If the location/size of the lesions makes it difficult, non-radical approach is a valuable option. Making prospective studies in echinococcosis is very complex, due to the low prevalence of this pathology, except in endemic areas, and the impossibility for the randomization, since radical surgery is the gold standard and should be done as long as it is feasible.