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©The Author(s) 2026.
World J Gastroenterol. Jan 21, 2026; 32(3): 114226
Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.114226
Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.114226
Table 1 Demographic and clinical characteristics of surgical and percutaneous treatment groups, mean ± SD/n (%)
| Variables | Surgical (n = 734) | Percutaneous (n = 255) | All patients | P value |
| Age (years) | 38.4 ± 15.9 | 38.1 ± 16.1 | 38.3 ± 16.0 | 0.801 |
| Gender | ||||
| Male | 176 (24.0) | 71 (27.8) | 247 (24.9) | 0.250 |
| Female | 558 (76.0) | 184 (72.2) | 742 (75.1) | |
| Number of cysts | ||||
| Single | 548 (74.7) | 192 (75.3) | 740 (74.8) | 0.850 |
| Two | 153 (20.9) | 49 (19.1) | 202 (20.4) | 0.450 |
| Multiple | 31 (4.2) | 14 (5.6) | 45 (4.6) | 0.350 |
| Location | ||||
| Right lobe | 518 (70.6) | 206 (80.9) | 724 (73.2) | 0.042a |
| Left lobe | 216 (29.4) | 49 (19.1) | 265 (26.8) | |
| Position | ||||
| Central | 292 (39.8) | 67 (26.4) | 359 (36.3) | 0.031a |
| Peripheral | 442 (60.2) | 188 (73.6) | 630 (63.7) | |
| Cyst type | ||||
| WHO CE1 | 479 (65.3) | 200 (78.6) | 679 (68.7) | 0.048a |
| WHO CE3a | 255 (34.7) | 55 (21.8) | 310 (31.3) | |
| Cyst longest diameter (mm) | 120.4 ± 47.8 | 118.2 ± 46.9 | 119.9 ± 47.6 | 0.620 |
| Initial volume (mL) | 421.1 ± 266.0 | 374.3 ± 295.2 | 410.0 ± 274.3 | 0.537 |
Table 2 Comparison of complications in surgical and percutaneous treatment groups, n (%)
| Type of complication | Surgical (n = 734) | Percutaneous (n = 255) | P value |
| Major complication | 155 (21.1) | 63 (24.7) | 0.234 |
| Cystobiliary fistula | 113 (15.4) | 43 (16.8) | 0.651 |
| Isolated cystobiliary fistula | 107 (14.6) | 38 (14.9) | 0.880 |
| Fistula + infection | 6 (0.8) | 5 (2.1) | 0.231 |
| Isolated cavity infection | 5 (0.7) | 0 (0) | 0.342 |
| Recollection | 9 (1.23) | 12 (4.71) | 0.001a |
| Recurrence | 8 (1.09) | 4 (1.57) | 0.550 |
| Anaphylaxis | 2 (0.3) | 4 (1.6) | 0.041a |
| Intraoperative iatrogenic injury | 20 (2.7) | 0 (0) | 0.002a |
| Diaphragm | 6 (0.8) | 0 (0) | |
| Liver | 12 (1.6) | 0 (0) | |
| Intestinal | 2 (0.3) | 0 (0) | |
| Mortality | 0 (0) | 0 (0) | |
| Minor complications | 172 (23.4) | 47 (18.4) | 0.092 |
| Pain | 143 (19.5) | 28 (11.0) | 0.002a |
| Fever | 27 (3.7) | 9 (3.5) | 0.891 |
| Pleural effusion | 27 (3.7) | 8 (3.1) | 0.690 |
| Urticaria | 2 (0.3) | 2 (0.8) | 0.262 |
| Incisional/umbilical hernia | 9 (1.2) | 0 (0) | 0.067 |
Table 3 Comparison of clinical characteristics of surgical and percutaneous patients developing cystobiliary fistula, mean ± SD/n (%)
| Variables | Surgical (n = 113) | Percutaneous (n = 43) | Total (n = 156) | P value |
| Cystobiliary fistula | 113/734 (15.4) | 43/255 (16.8) | 156/989 (15.8) | 0.651 |
| Intraoperative detection | 94/113 (83.2) | 12/43 (27.9) | 106/156 (67.9) | < 0.001a |
| Intraoperative primary suture | 94/113 (83.2) | 0/43 (0) | 94/156 (60.3) | |
| Postoperative bile drainage via catheter/drain | 64/113 (56.6) | 43/43 (100) | 107/156 (68.6) | < 0.001a |
| Spontaneous closure | 47/64 (73.4) | 33/43 (76.7) | 80/97 (82.4) | 0.825 |
| Secondary operation | 7/113 (6.2) | 2/43 (4.6) | 9/156 (5.8) | 1.000 |
| Postoperative ERCP | 10/113 (8.8) | 10/43 (21.8) | 20/156 (12.8) | 0.033a |
| Spontaneous closure time (days) | 14.2 ± 7.3 | 11.7 ± 9.4 | 13.0 ± 8.6 | 0.110 |
Table 4 Comparison of clinical parameters in patients with and without fistula development, mean ± SD
| Parameter | Treatment group | Cystobiliary fistula (+) | Cystobiliary fistula (-) | P value |
| Hospital stay (days) | Surgical | 10.3 ± 5.7 | 6.7 ± 6.0 | 0.002a |
| Percutaneous | 9.4 ± 4.9 | 2.7 ± 1.5 | < 0.001a | |
| All patients | 9.9 ± 5.3 | 5.4 ± 4.6 | < 0.001a | |
| Catheter removal time (days) | Surgical | 8.3 ± 4.9 | 5.9 ± 2.7 | 0.018a |
| Percutaneous | 17.8 ± 8.7 | 3.5 ± 2.9 | < 0.001a | |
| All patients | 13.0 ± 8.9 | 4.5 ± 3.2 | < 0.001a | |
| Initial volume (mL) | Surgical | 774.8 ± 513.2 | 356.7 ± 95.6 | < 0.001a |
| Percutaneous | 700.9 ± 288.2 | 346.5 ± 279.2 | < 0.001a | |
| All patients | 726.8 ± 397.6 | 351.1 ± 226.4 | < 0.001a |
Table 5 Clinical parameters and operation times of surgical and percutaneous groups, mean ± SD
| Features | Surgical (n = 734) | Percutaneous (n = 255) | All patients | P value |
| Final volume of cyst (mL) | 46.9 ± 38.8 | 63.3 ± 55.6 | 53.5 ± 45.9 | 0.025a |
| Final reduction rate (%) | 88.9 | 83.1 | 86.6 | 0.005a |
| Follow-up imaging duration (months), median (IQR) | 12.0 (3.0-60.0) | 18.6 (8-60) | 13.7 (3-60) | < 0.001a |
| Hospital stay (days) | 7.3 ± 6.2 | 3.1 ± 2.3 | 6.3 ± 5.8 | < 0.001a |
| Catheter removal time (days) | 6.6 ± 5.3 | 5.5 ± 6.4 | 6.3 ± 5.6 | 0.014a |
| Operation time without complications (minutes) | 81.3 ± 27.6 | 40.4 ± 6.2 | 70.6 ± 31.5 | < 0.001a |
| Operation time in patients with complications (minutes) | ||||
| Diaphragm injury (n = 6) | 163.3 ± 81.4 | |||
| Intestinal injury (n = 2) | 187.8 ± 53.1 | |||
| Liver injury (n = 12) | 115.6 ± 62.1 | |||
| Suturing and/or omentopexy in bile fistula | 103.1 ± 35.6 |
- Citation: Tahtabasi M, Kaya E, Yalcin M, Kaya V. Percutaneous vs surgical management of World Health Organization cystic echinococcosis 1 and 3a liver hydatid cysts. World J Gastroenterol 2026; 32(3): 114226
- URL: https://www.wjgnet.com/1007-9327/full/v32/i3/114226.htm
- DOI: https://dx.doi.org/10.3748/wjg.v32.i3.114226