The following is a summary of “Liver dome hydatid cyst surgery: Laparotomy or thoracotomy?,” published in the January 2023 issue of Primary care by Aghajanzadeh, et al.

The liver is the most common organ susceptible to hydatid cyst infection (75%), with the right lobe being more commonly affected. However, the involvement of the liver dome and segments 7 and 8 of the right lobe has yet to be previously reported. Therefore, surgery is the preferred treatment for liver hydatid cysts.

A retrospective analysis was conducted on 240 patients who underwent surgery for liver hydatid cysts between 2005 and 2017. The study analyzed the variables of gender, age, number of cysts, lobe and segment involvement, simultaneous lung and liver involvement, laparotomy, thoracotomy, patients referred due to the lack of finding cysts, and surgical complications.

Most patients were male, aged 8 to 68 years old. Right lobe involvement was observed in most cases, with 62 patients showing involvement of the liver dome and segments 7 and 8. These patients underwent thoracotomy, while the remaining patients underwent laparotomy (n = 178). Of the thoracotomy patients, 46 had the potential for capitonnage during the surgery, and the pain score was rated as 4-5 on the VAS scale. The rate of using analgesic drugs did not show a significant difference between the two surgical methods.

To prevent complications such as cyst rupture during manipulation, a new method using computed tomography (CT) scan was introduced in the study to aid in successful surgery. The method may help reduce complications and legal complaints associated with hydatid cyst surgery.

Reference: journals.lww.com/jfmpc/Fulltext/2023/01000/Liver_dome_hydatid_cyst_surgery__Laparotomy_or.7.aspx