Long-term outcomes after open total pericystectomy for cystic echinococcosis.

Background: Liver hydatid cysts (LHC) liver requires effective surgical treatment. Open closed total pericystectomy removes the entire echinococcus cyst while preserving healthy liver tissue.

Aim: To evaluate the outcomes of pericystectomy and its efficacy as a treatment modality for cystic echinococcosis (CE).

Methods: Thirty-eight patients were analyzed after open total pericystectomy at the University Hospital of Cologne between January 2006 and January 2024. Demographic, clinical, and laboratory parameters were collected retrospectively. Intraoperative data and postoperative complications were documented and classified using the Clavien-Dindo classification. Throughout the follow-up period, patients underwent regular clinical, serological, and sonographic evaluations both at the outpatient department and by their general physicians.

Results: Fifty-four cysts were treated with open total pericystectomy. Multiple cysts were found in 42.2% of cases. Singular cysts occurred in 57.8%. The right hepatic lobe was affected in 66.7%. Ectopic cysts occurred in 4 patients in the lung (n = 3) and spleen (n = 1). Median cyst size was 6.78 cm × 5.92 cm (range: 1.4-20.0 cm). The median surgical time of pericystectomy was 189 minutes (range: 78-455 minutes) with a median blood loss of 400 mL (range: 100-1400 mL). The complication rate (Clavien-Dindo > III) was 21.1%. The average hospital stay was 12.5 days. No recurrent disease could be detected after a median follow-up time of 97 months (range: 4-216 months). No recurrent cyst manifestation, postoperative liver failure or death was observed.

Conclusion: The presented surgical procedure known as open total pericystectomy is a safe surgical technique in treatment of cystic echinococcosis.