Review of the treatment of liver hydatid cysts

Table 1 Randomized controlled trials included in the analysis[10-12,18]

RCT	Year	Treatment	Endpoint	Size	Number of cysts per group	Mean cyst size (cm)	P < 0.05	Jadad Score
Khuroo et al[34]	1993	ALB flow diagram s PD vs ALB+ PD	Echo P	33	10, 12, 11	9.2 ± 4.4; 10.8 ± 3; 8.8 ± 4.5	Yes	2
							ALB + PD > ALB alone
Gil-Grande et al[7]	1993	ALB 1-3 mo vs PLB + S	Viability	55	18, 18, 19	10.4 ± 4; 8.91± 4; 10.5 ± 5	Yes	5
							ALB 3 mo > ALB 1 mo > no ALB
Khuroo et al[35]	1997	ALB + PD vs S alone	Echo P	50	25, 25	8 ± 3; 9.1 ± 3	Yes	3
							ALB + PD > S alone
Dziri et al[54]	1999	OP vs no OP	Deep abscess	115	58, 57	50; 502	Yes	2
							OP > no OP
Franchi et al[6]	1999	ALB vs MBZ	Echo P	448	178, 440	-	Yes	2
							ALB > MBZ
Keshmiri et al[8]	2001	ALB vs PLB	Echo P	29	49, 191	74.01 ± 130.79; 198.13 ± 403.711	Yes	4
							ALB > PLB
Bildik et al[9]	2007	ALB 1-3 mo vs no ALB + S	Viability	84	-	-	Yes	1
							ALB 3 mo > no ALB
Yüksel et al[15]	2008	Radical S vs conservative	Early recurrence; cavity complications	32	15, 17	7.8; 8.1	Yes	3
							Radical > Conservative
Shams-Ul-Bari et al[29]	2011	ALB + S vs S alone	Viability	72	36, 36	-	Yes	3
							ALB + S > S alone

¹Mean volume of cysts in cm³;

²Median size of the cavity in cm². Degenerative imaging changes assessed through echography. Viability: Viability of hydatid disease; Echo P: Echo pattern; S: Surgery; ALB: Albendazole; PD: Percutaneous drainage; PLB: Placebo.

Table 2 Literature studies involving laparoscopy approach in liver hydatid cyst

Ref.	Year	Study design	Size	Surgical modality	Conversion1	Complicationrate2	Recurrencerate	Follow-up(mo)
Emel´ianov et al[56]	2000	Prospective	37	Partial cystectomy	3%	10%	-
		Non-comparative
Khuory et al[57]	2000	Prospective	108	Marsupialization3	11%	3%	3.6%	4-54
		Non-comparative
Bickel et al[58]	2001	Prospective	31	Puncture + parasite neutralization + evacuation	3%	16%	0%	9-97
		Non-comparative
Polat[59]	2012	Retrospective	Open n = 12	Cystectomy		13%	0%	24
		Comparative	Lap4n = 7		0%	14%	0%
Zaharie et al[60]	2013	Retrospective	Open n = 271	Partial cystectomy		14%	0%	6-40
		Comparative	Lap4n = 62		4.85%	0%	0%	6-32

¹The main reasons for conversion to open surgery were bleeding and difficult location of the cyst;

²Wound infection, cyst rupture, anaphylactic reaction, hemorrhage, atelectasis, pneumonia and hernia. One patient died 1 mo postoperatively of candida sepsis in the Bickel et al[58] study and 1.16 % (2 patients) for open surgical procedure in the Zaharie et al[60] study. No postoperative mortality was observed in the others studies;

³Conversion the closed cavity of the cyst into an open pouch by incising it and suturing the edges of its wall to the edges of the wound;

⁴Laparoscopy approach.