Historical changes in surgical strategy and complication management for hepatic cystic echinococcosis

Table 1 Main surgical methods for hepatic cystic echinococcosis and their complications in different periods

Period (year)	Surgical methods	Major complications
Initial stage
1871	Excision of the internal capsule	Recurrence in situ, abdominal implantation, biliary fistula, and residual cavity infection
Mature stage
1965	Complete removal of the external capsule and hepatectomy	Intraoperative hemorrhage, cyst rupture, and liver dysfunction
1985	Percutaneous puncture and catheter drainage	Allergic reaction, abdominal implantation, residual cavity infection, biliary fistula, and recurrence in situ
2002	Modified excision of the internal capsule	Abdominal implantation and biliary fistula
2010	Internal capsule removal combined with external capsule subtotal resection	Recurrence in situ, disseminated implantation, and biliary fistula
Current stage
1992	Laparoscopic cyst excision	Intraoperative hemorrhage and cyst rupture
1994	Local ablation	Damage to surrounding tissues and organs. Allergic reaction, cyst rupture, abdominal implantation, and recurrence in situ
2002	Liver transplantation	Organ shortage, postoperative complications, and high cost