Surgery for hydatid cyst of the liver

Hydatid cyst (cystic echinococcosis) is a parasitic disease common in North Africa. It is caused by the larva of a small dog tapeworm (Echinococcus granulosus): people become infected through contaminated food or hands. In the liver, sometimes in the lung or other organs, the larva forms a fluid-filled pouch that grows slowly over years. Surgical treatment aims to remove the parasite without spreading it in the abdomen. The operating field is protected with swabs soaked in a product that kills the parasite, the cyst is punctured and sterilised, and its contents are removed. The surgeon then removes the protruding part of the cyst wall (unroofing) or, when possible, the whole cyst with its outer layer (pericystectomy). Any communication with the bile ducts is looked for and closed. Depending on location, the operation is performed laparoscopically or through open surgery. Surgery is offered for active, large or complicated cysts (infection, rupture into the bile ducts) or those located near important structures. Some small inactive or calcified cysts can simply be monitored. Antiparasitic tablets (albendazole) are often given before and after surgery. At Clinique Pasteur Tunis, the assessment includes ultrasound, CT or MRI and serology. The operation is carried out by a team familiar with this condition, which is common in the region, with ultrasound follow-up after surgery.