El Malki et al identified risk factors predictive of deep abdominal complications following surgery for a hepatic hydatid cyst. This can help identify a patient who may experience problems after operative management. The authors are from Hopital Ibn Sina and University Mohammed Vth Souissi in Rabat, Morocco.
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.
Specialty: Infectious Diseases
ICD-10: ,