Predictive factors of morbidity after surgical treatment of hepatic hydatid cyst

  • Heikal Bedioui
  • Khouloud Bouslama
  • Houcine Maghrebi
  • Jokho Farah
  • Hichem Ayari
  • Hamadi Hsairi
  • Montacer Kacem
  • Mohamed Jouini
  • Zoubeir BenSafta

Abstract

Introduction Surgery remains the basic treatment of hepatic hydatid cyst (HHC). However, it is associated with significant morbidity. The aim of our study was to evaluate mortality and morbidity of surgery of the HHC and to highlight the risk factors. Methods A retrospective study was conducted from January 1, 1996 to December 31, 2006. 391 patients hospitalized for HHC and operated in the Department of General Surgery “A” of the Rabta Hospital in Tunis, Tunisia. Results The overall mortality rate was 0.7% while the overall morbidity rate was 20.4%. About 16.6% suffered from specific complications, while 3.8% suffered from non-specific complications. Predictors of morbidity in a univariate analysis included cysts larger than 9 cm, dome cysts, cysts with bilious contents, type II, III, IV or V on ultrasound classification, fissured cysts and intrabiliary rupture of hepatic hydatid cyst. The multivariate study consisted of independent predictors of disease at the site of the liver dome, the cysto-biliary fistula and intrabiliary rupture of hepatic hydatid cyst Conclusion The hepatic hydatid cyst of the dome and the existence of preoperative complications in particular intrabiliary rupture of hepatic hydatid cyst are the main factors of morbidity. A better understanding of these factors allows the surgeon to choose the appropiate surgical technique that is associated with less morbidity.

Pan African Medical Journal 2012; 13:29

Author Biographies

Heikal Bedioui
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Khouloud Bouslama
Department of Gastroenterology, Charles Nicolle Hospital, Faculty of Medicine of Tunis, Tunisia
Houcine Maghrebi
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Jokho Farah
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Hichem Ayari
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Hamadi Hsairi
Department of Statistics, Ministry of Public Health, Tunisia
Montacer Kacem
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Mohamed Jouini
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Zoubeir BenSafta
Department of Surgery "A" Rabta Hospital, Tunis, Faculty of Medicine of Tunis, Tunisia
Published
2013-02-25
Section
Articles

Journal Identifiers


eISSN: 1937-8688