Surgical Outcomes in Hepatic Hydatid Disease: A Case Series of 153 Patients

Hepatic hydatid disease, caused by Echinococcus granulosus, remains a significant public health concern in endemic regions. This retrospective study analyzed 153 cases treated surgically at the General Surgery Department of Ibn Rochd University Hospital in Casablanca from 2019 to 2022. The majority of patients were women from rural areas, with a mean age of 45. Right upper quadrant pain was the predominant symptom. Diagnosis was primarily based on ultrasound using the Gharbi classification, with CT and MRI providing further anatomical detail. The most affected hepatic segments were VI, VII, and VIII. All patients underwent open surgery, mainly via right subcostal laparotomy, with dome resection being the most common technique. Biliary fistulas were identified in 13.72% of cases. Postoperative recovery was uneventful in over 93% of patients, with a low recurrence rate. The discussion highlights the importance of imaging in diagnosis, the role of serology, and surgical principles, including intraoperative exploration and bile duct assessment. Although drug therapy and minimally invasive methods are evolving, open surgery remains the cornerstone of treatment in complex or advanced cases.