Conclusions The lot was characterized by heterogeneity regarding the
gender, age and environment of origin. There was a slight
female predominance and an increased share of the 30-49
age group. The age range was between 18 and 84 years old,
mentioning the fact that the Surgical Clinic is one for adults.
From the clinical examination, we highlight the high
percentage of asymptomatic patients, which confirms
once again the high frequency of accidental diagnosis
in hepatic hydatid cyst. The most frequent symptom at
patients’ admission is represented by pain located at the
level of the right hypocondrium, a nonspecific symptom.
The fact that the results obtained are for cases referred for
surgical treatment and may differ from those obtained at
the first diagnosis (frequently in another clinic) and prior to
treatment with Albendazole must not be forgotten.
Laboratory examinations revealed hepatic cytolysis
syndrome most frequently with elevated ALT values (and in
cases where additional hepato-biliary pathologies were not
associated), inflammatory syndrome evaluated by a single
parameter (fibrinogen) and eosinophilia (39% of cases).
As previously shown, there are several factors that can
justify the clinical and paraclinical changes noticed besides
the hydatid cyst. Among these, we can list associated
comorbidities and the administered medication, diagnosis
and treatment in other medical units, and prior treatment
with Albendazole.
Imaging, especially the ultrasound examination, was
the basis for pre-surgical characterization of cysts. Most of
the cysts were CE3 and CE1 stages and, in terms of size,
between 5 and 10 cm diameter. The right lobe has been
affected in more than half of the cases.
Regarding the minimum invasive treatment, the MoCAT
and PAIR techniques were used. Among the open surgical
procedures, in 88% of the cases, the Lagrot technique
was used. The comparison between classic and minimally
invasive surgical treatment revealed fewer complications and
fewer necessary days of hospitalization in favor of the latter.
Summarizing, the following can be said:
— patients with hepatic hydatid cyst form a
heterogeneous group (taking into account
gender, age, place of origin);
— semiology is poor and unspecific;
— among laboratory examinations, eosinophilia
is a sign of concern that should place the
hydatid liver cyst on the differential diagnosis
list;
— imaging, most commonly in the form of
ultrasound examination, the easy, cheap and
non-irradiation method is the basis of the
diagnosis of hepatic hydatid cyst;
— minimally invasive methods have high
applicability, less frequent complications and
shorter hospitalization;
— the therapeutic solution for the hepatic hydatid
cyst remains the attribute of general surgery,
both by the still important role of classical
and laparoscopic surgical techniques and by
the ability of surgery to provide therapeutic
assistance to cases treated through minimally
invasive techniques.