Experience in the surgical treatment of hepatic hydatidosis

Of 1290 cases of hydatidosis hospitalized, 907 (70.3%) cases of hepatic hydatid cyst (HHC) were treated surgically (1954-1990). Of the 907 cases, 484 (53.3%) were males and 423 (46.7%) females. Hepatic hydatid cysts were single in 54%, multiple in 21.2% and complicated with hydatid cysts of other organs in 24.8%. 67.5% of the cysts were in the right lobe of the liver, 15.6% in the left lobe, 16.9% in both lobes. 79.0% were situated in the right lower part of the liver, 21.0% on the dome of the liver. Rupture of the cysts into biliary system, peritoneal cavity, the thorax (pulmonary-bronchial tree) and the pericardial sac were 35 (30%), 50 (42.6%), 31 (26.5%) and 1 case (0.9%) respectively. There were 5 deaths. Our experiences include: (1) routine intravenous drip of corticosteroids to alleviate the possible occurrence of allergic reaction during the operation and postoperative hyperpyrexia. (2) mebendazole or albendazole (ABZ) 20 mg/kg/d for one week before operation and 1-2 courses (1 course = 30 days) after operation to destroy the protoscoleces left in the body during operation. (3) antibiotics administration in complicated cases. (4) closure of intrahepatic biliary fistula.