Recurrent hydatid disease, a case report and literature review


  • Frances M. Lee Department of Upper GI Surgery, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia
  • Rafael Gaszynski Department of Upper GI Surgery, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia
  • Neil Merrett Department of Upper GI Surgery, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia



HD, Hydatid cyst, Hepatic HD, Echinococcus, Parasite


Hydatid disease (HD) remains endemic in Australia, with estimated incidence highest in rural and indigenous populations. Its recurrence is defined by new active cysts arising after appropriate therapy, and affects anywhere between 2-25% of total cases. Available treatment options include surgical resection, percutaneous drainage, and chemotherapy. Interestingly, their individual contributions to long-term minimisation of recurrence are scarcely described in the literature. We present a unique case of a 27-year-old female with recurrent hepatic HD requiring repeat operations and long-term chemotherapy. Prevention and treatment of recurrent HD requires careful evaluation of a multitude of factors, including disease characteristics, patient attributes, physician expertise and availability of resources. Consistent long-term follow up is required to better ascertain the long-term efficacy of reported treatment modalities for preventing recurrence. Despite a growing body of research looking at treatment of HD, there remains a considerable amount of controversy regarding most effective approach for minimising and preventing its recurrence.


Akhan O, Yildiz AE, Akinci D, Yildiz BD, Ciftci T. Is the Adjuvant Albendazole Treatment Really Needed with PAIR in the Management of Liver Hydatid Cysts? A Prospective, Randomized Trial with Short-Term Follow-Up Results. Cardio Vascular Interventional Radiol. 2014;37(6):1568-74.

Al-Shareef Z, Hamour OA, Al-Shlash S, Ahmed I, Mohamed AA. Laparoscopic treatment of hepatic hydatid cysts with a liposuction device. J Society Laparoendoscopic Surg. 2002;6(4):327-30.

Arif SH, Shams-ul-Bari, Wani NA, Zargar SA, Wani MA, Tabassum R et al. Albendazole as an adjuvant to the standard surgical management of hydatid cyst liver. Int J surg. 2008;6(6):448-51.

Unal A, Yazici P, Onen Z, Ozsoy M, Zeytunlu M, Kilic M, Coker A. The optimal treatment of hydatid cyst of the liver: Radical surgery with a significant reduced risk of occurrence. Turk J Gastroenterol. 2008;19(1):33-9.

Baskaran V, Patnaik, PK. Feasibility and safety of laparoscopic management of hydatid disease of the liver. J Society Laparoendoscopic Surg. 2004;8(4):359-63.

Bickel A, Loberant N, Singer-Jordan J, Goldfeld M, Daud G, Eitan A. The Laparoscopic Approach to Abdominal Hydatid Cysts. Arch Surg. 2001;136(7):789.

Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Tropica. 2010;114(1):1-16.

Yarnoz C, Fraile S, Trujillo A, De‐Liaño D, Ciga. Albendazole plus praziquantel versus albendazole alone as a pre‐operative treatment in intra‐abdominal hydatidosis caused by Echinococcus granulosus. Trop Med Int Health. 1998;3(6):462-6.

El Malki HO, El Mejdoubi Y, Souadka A, Zakri B, Mohsine R, Ifrine L et al. Does Primary Surgical Management of Liver Hydatid Cyst Influence Recurrence? J Gastrointestinal Surg. 2010;14(7):1121-7.

El Malki HO, Souadka A, Benkabbou A, Mohsine R, Ifrine L, Abouqal R et al. Radical versus conservative surgical treatment of liver hydatid cysts. Bri J Surg. 2014;101(6):669-75.

Ertem M. Laparoscopically Treated Liver Hydatid Cysts. Arch Surg. 2002;137(10):1170.

Franchi C, Vico B, Teggi A. Long‐Term Evaluation of Patients with Hydatidosis Treated with Benzimidazole Carbamates. Clin Infect Diseases. 1999;29(2):304-9.

Gollackner B, Längle F, Auer H, Maier A, Mittlböck, M, Agstner I et al. Radical Surgical Therapy of Abdominal Cystic Hydatid Disease: Factors of Recurrence. World J Surg. 2000;24(6):717-21.

Haddad MC, Sammak BM, Al-Karawi M. Percutaneous treatmerit of heterogertous predorninantly solid echopattern echinococcal cysts of the liver. Cardiovascular Interventional Radiol. 2000;23(2):121-5.

Ibrahim I, Tuerdi M, Zou X, Wu Y, Yasen A, Abihan Y et al. Laparoscopic versus open surgery for hepatic cystic echinococcosis: a systematic review and meta-analysis. Int J Clin Exp Med. 2017;10(12):16788-97.

Jenkins KJ, Power K. Human hydatidosis in New South Wales and the Australian Capital Territory 1987-1992. Med J Aust. 1996;164(1):18-21.

Jenkins DJ, Macpherson CN. Transmission ecology of Echinococcus in wild-life in Australia and Africa. Parasitology. 2003;127:S63-72.

Jenkins DJ. Cystic Echinococcosis in Australia: The Current Situation. Southeast Asian J Trop Med Public Health. 2004;35(1):183-8.

Yagci G, Ustunsoz B, Kaymakcioglu N, Bozlar U, Gorgulu S, Simsek A et al. Results of Surgical, Laparoscopic, and Percutaneous Treatment for Hydatid Disease of the Liver: 10 Years’ Experience with 355 Patients. World J Surg. 2005;29(12):1670-9.

Kabaalioğlu A, ÇEken K, Alimoglu E, Apaydin A. Percutaneous imaging-guided treatment of hydatid liver cysts: Do long-term results make it a first choice? Eur J Radiol. 2006;59(1):65-73.

Kahriman G, Ozcan N, Dogan S, Karaborklu O. Percutaneous treatment of liver hydatid cysts in 190 patients: a retrospective study. Acta Radiologica. 2016;58(6):676-84.

Kapan M, Kapan S, Goksoy E, Perek S, Kol E. Postoperative Recurrence in Hepatic Hydatid Disease. J Gastrointestinal Surg. 2006;10(5):734-9.

Kathouda N, Hurwitz M, Gugenheim J, Mavor E, Mason RJ, Waldrep DJ et al. Laparoscopic Management of Benign Solid and Cystic Lesions of the Liver. Ann Surg. 1999;229(4):460-6.

Khuroo MS. Hydatid Disease: Current Status and Recent Advances. Annals of Saudi Medicine. 2002;22(1–2):56–64.

Lam VWT, Merrett ND. Drainage of hepatic hydatid cyst with a surgiport. ANZ Journal of Surgery. 2005;75(11),1022–3.

Magistrelli P. Surgical Treatment of Hydatid Disease of the Liver. Archives of Surgery. 1991;126(4),518.

Menezes Da Silva A. Hydatid cyst of the liver—criteria for the selection of appropriate treatment. Acta Tropica. 2003;85(2),237-42.

Mohamed AE, Yasawy MI, Al Karawi MA. Combined albendazole and praziquantel versus albendazole alone in the treatment of hydatid disease. Hepato-gastroenterology. 1998;45(23):1690-4.

Moro P, Schantz PM. Echinococcosis: a review. Int J Infect Dis. 2009;13(2):125-33.

Mottaghian H, Saidi F. Postoperative recurrence of hydatid disease. Brit J Surg. 1978;65(4):237-42.

Mueller PR, Dawson, SL, Ferrucci JT, Nardi GL. Hepatic echinococcal cyst: successful percutaneous drainage. Radiology. 1985;155(3):627-8.

Nayman A, Guler I, Keskin S, Erdem TB, Borazan H, Kucukapan A, Ozbiner H, Batur A, Ertekin E, Feyzioglu B, Koc O, Kaya HE, Temizoz O, Kartal A, Ozbek O. A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience. Diagnostic and interventional radiology (Ankara, Turkey). 2016;22(1):47-51.

Papadimitriou J, Mandrekas A. The surgical treatment of hydatid disease of the liver. Brit J Surg. 1970;57(6):431-3.

Polat P, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A. Hydatid Disease from Head to Toe. RadioGraphics. 2003;23(2):475-94.

Prousalidis J, Kosmidis C, Anthimidis G, Kapoutzis K, Karamanlis E, Fachantidis E. Postoperative recurrence of cystic hydatidosis. Can J Surg. 2012;55(1):15-20.

Saremi F. Percutaneous drainage of hydatid cysts: use of a new cutting device to avoid leakage. Am J Roentgenol. 1992;158(1):83-5.

Sayek MD, I, Onat MDD. Diagnosis and Treatment of Uncomplicated Hydatid Cyst of the Liver. World J Surg. 2001;25(1):21-7.

Shams-Ul-Bari MA, Dass T, Arif S, Khaja A, Naikoo Z. Role of albendazole in the management of hydatid cyst liver. Saudi J Gastroenterol. 2011;17(5):343.

Sielaff TD, Taylor B, Langer B. Recurrence of Hydatid Disease. World J Surg. 2001;25(1):83-6.

Bedioui H, Bouslama K, Maghrebi H, Farah J, Ayari J, Hsairi H et al. Predictive factors of morbidity after surgical treatment of hepatic hydatid cyst. Pan Afri med j. 2012;13:29.

Aarons BJ, Kune GA. A suction cone to prevent spillage during hydatid surgery. Aust N Zeal J Surg. 2983;53(5):471-2.

Tasev V, Dimitrova V, Draganov K, Bulanov D, Popadiin N, Gaĭdarski R. Hepatic echinococcosis: radical or conservative surgical treatment. Khirurgiia. 2002;58(2):10-13.

Taylor DH, Morris DL. Combination chemotherapy is more effective in postspillage prophylaxis for hydatid disease than either albendazole or praziquantel alone. Brit J Surg. 1989;76(9):954.

Teggi A, Lastilla MG, De Rosa F. Therapy of human hydatid disease with mebendazole and albendazole. Antimicrobial Agents Chemotherapy. 1993;37(8):1679-84.

Ustünsöz B, Akhan O, Kamiloğlu MA, Somuncu I, Uğurel MS, Cetiner S. Percutaneous treatment of hydatid cysts of the liver: long-term results. Am J Roentgenol. 1999;172(1):91-6.

Velasco-Tirado V, Alonso-Sardón M, Lopez-Bernus A, Romero-Alegria A, Burguillo FJ, Muro A et al. Medical treatment of cystic echinococcosis: systematic review and meta-analysis. BMC Infect Dis. 2018;18:306.

Yaghan R, Heis H, Bani-Hani K, Matalka I, Shatanawi N, Gharaibeh K et al. Is fear of anaphylactic shock discouraging surgeons from more widely adopting percutaneous and laparoscopic techniques in the treatment of liver hydatid cyst? Am J Surg. 2004;187(4):533-7.

Junghanss T, Menezes da Silva A, Horton J, Chiodini PL, Brunetti, E. Clinical management of cystic echinococcosis: state of the art, problems, and perspectives. Am j trop med hygiene. 2008;79(3):301-1.

Zaharie F, Bartos D, Mocan L, Zaharie R, Iancu C, Tomus C. Open or laparoscopic treatment for hydatid disease of the liver? A 10-year single-institution experience. Surg Endoscopy. 2013;27(6):2110-16.






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