Hydatid disease of the liver is still a major cause ofmorbidity in Greece. Beside the common complicationsof rupture and suppuration, calcification of thehepatic cysts represent a not well studied, less frequentand sometimes difficult surgical problem. Inthe present study 75 cases with calcified symptomaticliver echinococcosis were operated on in the1st Propedeutic Surgical Clinic between 1964 to1996. Twenty-eight patients were male and 47 femalewith ages from 23 to 78 years. The diagnosis wasbased mainly on the clinical picture and radiologicalstudies. In 5 cases the operative method wascystopericystectomy. We performed evacuation ofthe cystic cavity and partial pericystectomy andprimary closure of the residual cavity in 6 cases,omentoplasty or filling of the residual cavity with apiece of muscle of the diaphragm in 4 cases andexternal drainage by closed tube, in 60 cases. In 12 ofthose with drainage, after a period of time, a secondoperation with easy, removal of most of the calcareouswall plaques was performed. The mortality ratewas 2%.Our results could be considered satisfactory. Inthe calcified parasitic cysts of the liver the proposedtechnique is cystopericystectomy. An alternativeprocedure is pericystectomy and drainage witha “planned” reoperation with a bloodless, dueto intervening inflammation, chiseling of thecalcification.
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