Epidemiology and Early Complications of Lung and Liver Hydatid Cyst Surgery among Patients Referred to Afzalipour Hospital, Kerman University of Medical Sciences During 2003-2013

Document Type: Original Article


1 Student of Mdicine, Afzalipour School of Medicine and Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran

2 Associate Professor of Thorax Surgery, Afzalipour School of Medicine & Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

3 Resident of Psychiatry, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

4 Pathologist, Kerman University of Medical Sciences, Kerman, Iran

5 Associate Professor of Pulmonology, Afzalipour School of Medicine & Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran

6 Assistant Professor of Anesthesiology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran


Background and Aims: Hydatid cyst disease is one of the most common parasitic zoonotic diseases in Iran and the most common involved sites, are lungs and liver. The best treatment of this disease is surgery. The aim of this study was to evaluate the epidemiology and early complications of surgery of hydatid cyst of lung and liver in patients referred to Afzalipour Hospital afiliated to Kerman University of Medical Sciences during 2003-2013.

Method: In this cross-sectional study, 85 patients with lung or liver hydatid cyst who were referred to Afzalipour hospital during 2003-2013 were evaluated retrospectively. Data related to epidemiologic variables and surgery complications were obtained from patient’s documents.

Results: From 85 patients with hydatid cyst of lung and liver, 48.23% were male and 51.76% were female. Among patients, 69.4 % had lung hydatid cyst, 24.7% had liver hydatid cyst and 5.8% had both simultaneously. Cough, dyspnea and fever were dominant symptoms and almost all the surgeries were done through cystectomy with open drainage or cystectomy with capitonage. In whole, 12 cases (14%) had been complicated. There was no significant relation between the method of surgery and complications.

Conclusion: in the present study, the results of epidemiologic variables such as age, sex, prevalence of pulmonary and hepatic involvement and clinical manifestations were similar to the studies that were done in other cities of Iran and also previous studies in Kerman. From 85 surgeries, 12 cases were complicated and there was no significant relation between the method of surgery and complications. Method of surgery, result and complications were similar to other parts of the world and surgery is recommended to prevent hydatid cyst complications such as abscess, opening to the pleural cavity and anaphylactic shock.


  1. Thompson RCA. Echinococcosis In: Gillespie S (editor). Principles and Practice of Clinical Parasitology. London, John Wiley & Sons Ltd, 2001; PP585-612.
  2. Pejhan S, Lashakri Zadeh MR, Javaherzadeh M, Shadmehr MB, Arab M, Daneshvar Kakhki A, et al. Surgical Treatment of Complicated Pulmonary Hydatid Cyst. Tanaffos 2007; 6(1): 19-22.
  3. Gottstein B, Reichen J. Echinococcosis/Hydatidosis. In: Cook G (Editor), Manson s. Tropical Diseases. 20th ed., London, W.B. Saunders, 1996; PP1486-1508.
  4. Eckert J, Gemmell MA, Meslin FX, Powlowski ZS. WHO/OIE manual on echinococcosis in human and animals: Apublic health problem of global concern. 2002; 286.
  5. Ghafari Far F, Jaloosian F. The economic losses of human hydatidosis in patients referred to shariati and Imam Khomaini hospitals in Tehran. Proceeding of 4th National Iranian Congress on Parasitology and Parasitc diseases in Iran. Iran, Tehran, 2003; P67 [In Persian]
  6. Rokni MB. Echinococcosis/hydatidosis in Iran. Iran J Parasitol 2009; 4(2): 1-16.
  7. Ahmadi N.A. Badi. F. Human hydatidosis in Tehran, Iran: A retrospective epidemiological study of surgical cases between 1999 and 2009 at two university medical centers. Trop Biomed 2011; 28(2): 450-6.
  8. Asghari M, Mohebali M, kia EB, Farahnak A, Ariaeipour M, Asadian S et al. Seroepidemiology of Human Hydatidosis Using AgB-ELISA Test in Arak, Central Iran . Iran J Public Health 2013; 42(4): 391-6.
  9. Shahrokhabadi R, Rahimi E, Poursahebi R. Seroepidemiological study of human hydatidosis in Rafsanjan, Kerman. Zahedan J Res Med Sci (ZJRMS) 2014; 16(4): 46 [In Persian].
  10. Gangopadhyay AN, Srivastava P, Upadhyaya VD, Hasan Z. Is primary chemotherapy effective in large hydatid cyst of liver? J Indian Assoc Pediatr Surg 2009; 14(1): 40.
  11. Karaoglanoglu N, Kurkcuoglu IC, Gorguner M, Eroglu A, Turkyilmaz A. Giant hydatid lung cysts. Eur J Cardiothorac Surg 2001; 19(6): 914-17.
  12. Park KH, Jung SI, Jang HC, Shin JH. First successful puncture, aspiration, injection, and re-aspiration of hydatid cyst in the liver presenting with anaphylactic shock in Korea. Yonsei Med J 2009; 50(5): 717-20.
  13. Rahimi-Rad MH, Mahmodlou R. Multiple mediastinal hydatid cysts: a case report. Pneumologia 2009; 58(4): 230-2.
  14. Eftekhari F. Clinical and Demographic Features of Patients with Hydatid Cyst Admitted in Kerman University Hospitals between 1991-2000. Journal of Kerman University of Medical Sciences 2005; 12(4): 252-7 [In Persian].
  15. Bensghir M, Fjouji S, Bouhabba N, Ahtil R, Traore A, Azendour H, Kamili ND.Anaphylactic shock during hydatid cyst surgery. Saudi J Anaesth 2012; 6(2): 161-4.
  16. Islam MN, Khan NA, Haque SS, Hossain M, Ahad MA.Hepatic hydatid cyst presenting as cutaneous abscess. Mymensingh Med J 2012; 21(1): 165-9.
  17. Kuzucu A, Soysal O, Ozgel M, Yologlu S. Complicated hydatid cysts of the lung: clinicaland therapeutic issues. Ann Thorac Surg 2004; 77(4): 1200-4.
  18. Salem CO, Schneegans F, Chollet J, Jemli ME.Epidemiological studies on echinococcosis and characterization of human and livestock hydatid cysts in mauritania. Iran J Parasitol 2011; 6(1): 49-57.
  19. Nunnari G, Pinzone MR, Gruttadauria S, Celesia BM, Madeddu G, Malaguarnera G, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol 2012; 18(13): 1448-58.
  20. Fica A, Soto A, Slater J, Peralta M, Humeres R, Castro M,et al. Clinical presentation of hydatid disease during 15 years: a case series from Santiago, Chile. Rev Chilena Infectol 2012; 29(2): 183-91.
  21. Sayir F, Cobanoğlu U, Sehitoğulları A, Bilici S.Our eight-year surgical experience in patients with pulmonary cyst hydatid. Int J Clin Exp Med 2012; 5(1): 64-71.
  22. Sanli M, Tuncozgur B, Elbeyli L. Pulmonary hydatidosis and surgical therapy. Turkish J Thoracand Cardiovasc Surg 2000; 8: 703-5.
  23. Dogan R, Yuksel M, Cetin G, Suzer K, Alp M, Kaya S, Unlü M, Moldibi B. Surgical treatmentof hydatid cysts of the lung: report on 1055patients. Thorax 1989; 44(3): 192-9.
  24. Kosar A, Orki A, Hacıibrahimoglu G, Kiral H, Arman B. Effect of capitonagge and cystotomy on outcome of childhood pulmonary hydatid cysts. J Thorac and Cardiovasc Surg 2006; 132(3): 560-4.
  25. Kavukcu S, Kilic D, Tokat AO, Kutlay H, CangirAK, Enon S, et al. Parenchyma-preserving surgery in the management of pulmonary hydatid cysts. J Invest Surg 2006; 19(1): 61-8.
  26. Vahedi MA, Vahedi ML. Demographics of patients with surgical and nonsurgical cystic echinococcosis in East Azerbaijan from 2001 to 2012. Pak J Biol Sci 2012; 15(4): 186-91.
  27. Yu SH, Li DS, Ilyar S, Wu MB, Zhang LW.Analysis of surgery effect on 198 cases of pulmonary echinococcosis. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 2012; 30(1):45-8.
  28. Skerrett SJ, Plorde JJ. Parasitic infections of thepleural space. Semin Respir Med 1992; 13(2):248-54.
  29. Balci AE, Eren N, Eren S, Ulku R. Ruptured hydatid cysts of the lung in children: clinical review and results of surgery. Ann Thorac Surg 2002; 74(3): 889-92.
  30. Turna A, Yilmaz MA, Hacıibrahimoglu G, Kutlu CA, Bedirhan MA. Surgical treatment of pulmonary hydatid cysts: Is capitonnage necessary? Ann Thorac Surg 2002; 74(1): 191-5.
  31. Erdogan A, Ayten A, Demircan A. Methods of surgical therapy in pulmonary hydatid disease: Is capitonnage advantageous? ANZ J Surg 2005; 75(11): 992-6.
  32. Sokouti M, Golzari SE, Aghdam BA. Surgery of uncomplicated pulmonary hydatid cysts: Capitonnage or uncapitonnage? Int J Surg 2011; 9(3): 221-4.
  33. Polat FR. Hydatid cyst: open or laparoscopic approach? A retrospective analysis. Surg Laparosc Endosc Percutan Tech 2012; 22(3): 264-6.
  34. Agaoglu N, Türkyilmaz S, Arslan MK. Surgical treatment of hydatid cysts of the liver. Br J Surg 2003; 90(12): 1536-41.
  35. Chautems R, Buhler L, Gold B, Chilcott M, Morel P, Mentha G. Long term results after complete or incomplete surgical resection of liver hydatid disease. Swiss Med Wkly 2003; 133(17-18): 258-62.
  36. Franciosi CM, Romano F, Porta G, Caprotti R, De Fina S, Colombo G, et al. Surgical treatment of hydatid disease of the liver. An experience from outside the endemic area. Chir Ital 2002; 54(5): 667-72.
  37. Ayifuhan A, Tuerganaili A, Jun C, Ying-Mei S, Xiang-Wei L, Hao W.Surgical treatment for hepatic alveolar echinococcosis: report of 50 cases. Hepatogastroenterology 2012; 59(115): 790-3.
  38. Ramia JM, Ruiz-Gomez F, De la Plaza R, Veguillas P, Quiñones J, García-Parreño J. Ambispective comparative study of two surgical strategies for liver hydatidosis.World J Gastroenterol 2012; 18(6): 546-50.