Asymptomatic Liver Hydatid cysts; a Preferred Approach

Background: surgery is the accepted method for treatment ofcomplicated liver hydatid cysts. however, there is no consensusabout the most appropriate management of incidentallydiscovered asymptomatic echinococcal cysts of the liver. expectantmanagement poses many patients at risk while operatingall clinically silent liver hydatids, would impose burden onlocal health resources of endemic areas.methods: we investigated 47 patients with clinically silent,ultrasonographically diagnosed liver hydatids during a periodof one to ten years, to clarify the natural history of hepatic echinococcalcysts, patients had a single asymptomatic liverhydatid cyst. we offered the patients to choose surgical treatment,or medical treatment with albendazole. all patients declinedboth forms of treatment on grounds of not feeling particularlyill. forty-three patients came back for regular followupvisits lasted for 13 to 118 months. they were placed intothree distinct groups, depending on their ensuing clinicalcourse of disease.results: group a comprised of 16 patients whose initialcomplaints did not worsen nor developed new symptoms. inthese patients the largest diameter of the cysts became smalleror the cyst disappeared completely. group b consisted of 19asymptomatic patients. their liver cyst had increased in sizefrom 2 to 7 cm with a mean diameter of 3.4 ern on ultrasoundevaluation. group c consisted of 8 patients who returned withcomplications of the cysts.conclusion: because of low rate of complications among incidentallydiscovered liver cysts, we suggest medical treatment forsuch patients. operation can be reserved for complicated cases.