What question did this study set out to answer?

This study aims to identify factors that predict recurrence of hepatic hydatid cysts after surgery.

May 15, 2026International Journal of Infectious Diseases0 citationsOpen Access

Predictors of Recurrence After Surgery for Hepatic Hydatid Cysts: Survival Analysis and Risk Modeling from an Endemic Region

IIImen Ben IsmailTunis University MSMarwen SghaierCompagnie Africaine des Peintures HZHakim ZenaidiTunis El Manar University

Key Points

This study aims to identify factors that predict recurrence of hepatic hydatid cysts after surgery.
Conducted a retrospective analysis of patients between 2010 and 2022 who underwent surgery.
Evaluated clinical, radiological, and operative variables for their impact on recurrence.
Utilized Kaplan-Meier estimates and multivariable Cox regression for statistical analysis.
Of 117 patients, 9 (7.7%) experienced recurrence after a mean follow-up of 32 months.
Independent predictors of recurrence include cyst calcification (HR 3.6), gelatinous content (HR 4.1), and lack of omentoplasty (HR 3.9).
Albendazole therapy for ≥3 months significantly reduced recurrence risk (HR 0.28).

Abstract

BACKGROUND: Hepatic cystic echinococcosis remains endemic in many regions, and surgery is the mainstay of treatment. However, postoperative recurrence remains a significant concern. This study aimed to identify predictors of recurrence after surgical management. METHODS: We conducted a retrospective study including patients who underwent surgery for hepatic hydatid cysts between 2010 and 2022 in a tertiary center in Tunisia. Clinical, radiological, and operative variables were analyzed. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method and compared with the log-rank test. All variables were first assessed in univariate analysis; those with p < 0.10 were entered into a multivariable Cox regression model to identify independent predictors. RESULTS: A total of 117 patients were included. After a mean follow-up of 32 ± 14 months (median 30 IQR 18-44), recurrence occurred in 9 patients (7.7%). In multivariable analysis, cyst calcification (HR 3.6), gelatinous cyst content (HR 4.1), and absence of omentoplasty (HR 3.9) were independent predictors of recurrence. Albendazole therapy ≥3 months was associated with a reduced risk (HR 0.28). The model showed good discrimination (AUC 0.86). CONCLUSION: Recurrence after hepatic hydatid cyst surgery is influenced by cyst characteristics and operative management. A structured risk-factor analysis identified independent predictors that may guide postoperative follow-up.

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