Surgery and postoperative mebendazole in the treatment of hydatid disease

OBJECTIVE: Surgery was virtually the only curative method for hydatid disease until the early 1970s when studies have shown the safety and effectiveness of benzomidazole compounds for the treatment of hydatid cysts. Our aim is to establish the outcome of chemotherapy in the postoperative period on secondary hydatid cyst.

METHODS: Between 1987 to 1996 inclusive, all patients who were diagnosed with hepatic hydatid disease and who underwent surgery and received a post operative course of chemotherapy at Princess Basma Teaching Hospital, Irbid, North Jordan, were retrospectively reviewed with special referral to side effects of chemotherapy and recurrence rate of hydatid disease.

RESULTS: There were 78 patients (41 females, 37 males). All age groups were involved with an age range of 8-70 years. The main clinical presentation was upper abdominal discomfort, heaviness and mild pain. Ultrasonography and indirect hemagglutination test diagnosed more than 90% of cases. All patients were operated upon and received a postoperative prophylactic course of mebendazole. We reported a recurrence rate of less than 3%. Excessive loss of hair as a side effect to mebendazole therapy occurred in 2 young female patients.

CONCLUSION: The postoperative prophylactic course of mebendazole is reliable, safe and with minor side effects and the recurrence rate of the disease was reduced to the lowest possible levels.