Comparison of the Effectiveness and Complications of PAIR, Open Surgery, and Laparoscopic Surgery in the Treatment of Liver Hydatid Cysts.

: The aim of this study was to compare percutaneous aspiration injection reaspiration (PAIR), open surgery (OS), and laparoscopic surgery (LS) in the treatment of liver hydatid cysts in terms of effectiveness, complications, and recurrence rates. : This retrospective cross-sectional study included 383 patients who were treated with a diagnosis of liver hydatid cyst at Harran University Faculty of Medicine between May 2014 and May 2024. Patients were divided into three groups based on the treatment method: PAIR, OS, and LS. The groups were analyzed in terms of demographic and clinical characteristics such as age, sex, number of cysts, cyst location, and cyst diameter. Various factors such as complications, recurrence rates, and biliary fistula development were compared. Statistical analyses were performed using Jamovi and JASP software, and ≤ 0.05 was considered significant. : The risk of biliary fistula development was found to be significantly lower in patients treated using PAIR than in those in the surgical groups ( < 0.001). While the recurrence rate was higher in the PAIR group, the recurrence rates were similar in the OS and LS groups ( = 0.043). The risk of biliary fistula development and catheter removal time were found to be higher in patients with large cysts ( < 0.001). A strong and statistically significant correlation was observed between the length of hospital stay and the duration until catheter removal ( < 0.001). The maximum diameter of the cyst demonstrated a significant positive correlation with both the length of hospital stay (r = 0.363, < 0.001) and the duration until catheter removal ( < 0.001). : This study demonstrates that the PAIR method is effective in reducing biliary fistula development, but the recurrence rates are higher than OS and LS. OS and LS show similar outcomes in terms of recurrence.