Risk Factors of El Malki et al for Deep Abdominal Complications Following Surgery for a Hepatic Hydatid Cyst

 

Deep abdominal complications (DAC) of hydatid surgery include

(1) bile leakage

(2) biloma

(3) deep bleeding or hematoma

(4) deep abscesses (intrahepatic or subphrenic) or generalized peritonitis

 

Parameters

(1) preoperative complications

(2) number of cysts in the liver

(3) biliary fistula

(4) residual cyst management

(5) cyst wall (pericyst)

Parameter	Finding	Points
preoperative complications	absent	0
	present	1
number of cysts	1 or 2	0
	3 or more	1
biliary fistula	absent	0
	present	1
residual cyst management	capitonnage alone	1
	omentoplasty alone	1
	drainage OR (drainage + capitonnage)	0
pericyst width	supple	0
	thick	1

 

where:

• Capitonnage = surgical closure of a cyst with sutures pulling the cyst walls together.

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• A score >= 2 was associated with deep abdominal complications.

 

Performance:

• The sensitivity was 80% and the specificity was 59%.

• The positive predictive value was low at 30%, while the negative predictive value was 93%. This means that the main value of the score is to identify patients at low risk.