SURGICAL MANAGEMENT OF HEPATIC HYDATID CYST IN CHILDREN

Objective: To know the effectiveness of removal of hydatid cyst of liver along with pericyst (pericystectomy) as operative treatment, in terms of intra-operative and post-operative complications in the pediatric age group. Material and Methods: This study was conducted on paediatric patients with liver hydatid cysts at Department of Paediatric Surgery, Lady Reading Hospital, Peshawar from January 2000 to December 2006. All patients with ultrasound findings for hydatid cyst disease of the liver were included in the study. They were evaluated according to age, clinical presentation, ultrasound and CT scan findings for operative management. After Laparatomy through right transverse incision, half of the contents of the cyst were aspirated, refilled with hypertonic saline solution of the aspirated volume and after waiting for five minutes Pericystectomy was carried out, followed by careful examination and stoppage of any leakage of blood or bile from the residual cavity. In infected cases the cavity was drained. Results: Out of 21 paediatric patients operated for liver hydatid cysts during the study period, 11(52.4%) were girls and 10 (47.6%) were boys, with age ranging from 4 to 15 years. Cystectomy with tube drainage was performed in 20 patients while in one patient de-roofing was performed because of rupture. Hypertonic saline was used as a scoliocidal agent. There was no operative mortality. The mean hospital stay was 6.5+3.8 days. Recurrence after operation was seen in one (4.8%) patient. Conclusion: Hepatic hydatid cysts in children can be treated successfully by peri-cystectomy.