Gallbladder Hydatid Cyst: A Review on Clinical Features, Investigations and Current Management
Received 22 December 2019
Accepted for publication 24 March 2020
Published 2 April 2020 Volume 2020:13 Pages 87—97
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Wing-Kin Syn
Vipul D Yagnik,1 Sushil Dawka,2 Nitin Patel3
1Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat, India; 2Department of Surgery, SSR Medical College, Belle Rive, Mauritius; 3Department of Surgical Gastroenterology, Gujarat Superspeciality Hospital, Baroda, Gujarat, India
Correspondence: Vipul D Yagnik
Department of Surgical Gastroenterology, Nishtha Surgical Hospital and Research Centre, Patan, Gujarat 384265, India
Background: Gallbladder hydatid cyst (GBHC) is highly uncommon with an incidence of 0.3– 0.4% of all atypically located hydatid cysts. Our personal experience of one case of primary GBHC (PGBHC) managed laparoscopically motivated this systematic review. This study aimed to analyze the demographic characteristics, types [whether primary GBHC (PGBHC) or secondary GBHC (SGBHC)], clinical presentation, laboratory investigations, imaging studies, operative procedure, hospital stay, follow-up and recurrence.
Methods: A systematic review was performed using preferred reporting items for systematic reviews and meta-analyses guidelines.
Results: Twenty studies, including 22 cases plus one more case managed by us, were included in the review. For PGBHC, the mean age was 48.61 years while for SGBHC it was 47.9 years. PGBHC was more common in females (69.23%) while SGBHC was more common in males (55.55%). Overall, GBHC was more common in females (56.52%). The most common presentation overall was abdominal pain (100%) followed by nausea/vomiting (43.47%). The other common symptoms were nausea/vomiting (61.53%) and Murphy’s sign (38.46%) in PGBHC, but jaundice (50%) and fever (30%) in SGBHC. In PGBHC, 50% patients had normal liver function while this was deranged in 66.66% patients with SGBHC. Serology was positive in 50% of PGBHC and 100% in SGBHC. Ultrasonography was positive in 50%, while CT-scan showed 70%. CT-scan was better at detection of SGBHC (100%). The most common operation was open cholecystectomy (78.26%) either isolated or combined. Isolated open cholecystectomy was commonly done in PGBHC (69.23%). Overall, only 56.52% of patients received albendazole, but no recurrence was reported. The average hospital stay was 7.25 days and follow-up ranged from 1 month to 10 years.
Conclusion: GBHC mostly affects females with abdominal pain being the most common symptom. Ultrasonography is expedient though CT-scan is more sensitive. Albendazole monotherapy has questionable value. Open cholecystectomy is the most common operation. However, laparoscopy is safe in experienced hands.
Keywords: hydatid, cyst, gallbladder, primary, secondary
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