Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications

Background This study was designed to test a hypothesis that intrahepatic hydatid cyst location can effect the incidence of cystobiliary communications and the cavity-related complications. Methods A total of 121 cysts treated by conservative surgical methods in 113 patients were evaluated prospectively. Cysts were grouped as near to the liver hilum (segment I, III, IVb, V, and VI) and far from the hilum (segment II, IVa, VII, and VIII). Results There were 58 (48%) hilar and 63 (52%) peripheral cysts. We found more cystobiliary communications (48% versus 27%, P = 0.015), more biliary leakage (36% versus 10%, P <0.001), and more biliary fistula (12% versus 3%, P = 0.080) in the cysts near to the hilum than far from the hilum. Postoperative hospital stay was longer in the cysts near to the hilum (12.3 ± 3.1 days) than the cysts far from the hilum (7.7 ± 2.7 days, P = 0.022). Conclusions The location of the hydatid cyst near to the liver hilum is a risk factor for the cystobiliary communications and the cavity related complications.