[Complications after removal of hepatic echinococcal cysts and possibilities of their prevention].

Operative treatment of hydatid disease is the only radical method at present. According to the data in the literature, the incidence of postoperative complications in patients with hydatid disease of the liver ranges from 14.32 to 64%. The work generalizes the results of operations in 278 patients with hepatic hydatid disease. Closed echinococcectomy was conducted in 168 (65.87%) patients, partly closed--in 34 (12.23%), open echinococcectomy--in 14 (5.04%), pericystectomy--in 21 (7.55%), ideal echinococcectomy--in 17 (6.12%), resection of the liver with removal of the hydatic cyst--in 15 (5.4%), and percutaneous transhepatic drainage of the cyst--in 9 (3.2%) patients. Postoperative complications occurred in 32 (11.51%) cases. Among them were suppuration of the residual cavity in 19, external biliary fistula in 11, and subdiaphragmatic abscess in 2 patients. The least number of complications was encountered after closed echinococcectomy--in 5 (2.97%) patients. One patient died after partly closed echinococcectomy as the result of development of multiple cholangiogenous hepatic abscesses. The results of the authors' observations provide evidence that the character and frequency of postoperative complications are determined by timely diagnosis of echinococcosis of the liver before the development of complicated forms, correct choice of the type of the operation, and the techniques of the operation and the operative approach.