Analysis of Complications of a Neglected Disease: 13 Years of Experience with Liver Hydatid Cysts in a High-Volume Hospital.

: The aim of this study was to evaluate the clinical presentation, treatment outcomes, and complications associated with hepatic hydatid cysts in a pediatric population. : This retrospective study analyzed 214 pediatric patients with liver hydatid cysts, focusing on clinical presentation, treatment outcomes, and associated complications. Patients were classified based on treatment modality, including non-operative management with albendazole, PAIR, and surgical intervention. This study compared cyst characteristics, recurrence rates, and complications such as cysto-biliary fistulas. : Among the patients, 68% ( = 145) had a single cyst and 86% ( = 184) were found to have isolated liver cysts. No significant statistical difference was observed between Group 1 and Group 2 in terms of age, gender, and basic laboratory values and general characteristics of the cysts, such as the lobe where the cyst was located, involvement of multiple organs, number of cysts, the state of cyst rupture, and recurrence; no statistically significant difference was found between the groups ( > 0.05 for each comparison). Cyst rupture incidence was 6%, and the average incidence of recurrence was 2%, with a surgical recurrence incidence of 3%. A total of 37 patients had a laparotomy, while 7 had laparoscopic surgery. In total, capitonnage was performed in 68 patients, omentopexy in 4, and cystostomy in 6. Consequently, among the treated patients (PAIR + surgery), the incidence of cysto-biliary fistula was 11%, anaphylaxis was 2%, surgical recurrence was 3%, and the incidence of reoperation (Clavien-Dindo ≥ 3) was 6%. The average follow-up period was 72 months, during which no mortality was observed. : We identified key clinical outcomes related to both non-surgical treatments (cyst rupture and recurrence) and surgical groups (cysto-biliary fistulas, anaphylaxis, the need for reoperation, rupture, and recurrence).