Postoperative recurrence in hepatic hydatid disease

Recurrence of hepatic hydatid disease is still a serious problem in endemic areas like our country. In this study, we present the causes and management of recurrences after surgical therapy of the hepatic hydatid cysts. Hepatic hydatid cyst patients treated surgically and followed afterward at Istanbul University, Cerrahpasa Medical Faculty, Department of General Surgery between January 1998 and January 2003 were evaluated retrospectively. During this period, 172 primary patients with hepatic hydatid disease were attended to at our clinic. Morbidity and mortality rates for this series were 5.8% and 0.58%, respectively. Recurrence rate was 4.65% during the follow-up period of 60.5 months (range, 25-84 months). Primary causes of recurrence were thought to be unnoticed cysts with exophytic development due to inadequate incision and exposition and spreading of the disease during conservative operative interventions. It is concluded that selection of the proper incision allowing complete exposition, and performance of pericystectomy in solitary, peripherally located cysts prevent recurrence.