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A series of 74 consecutive patients (48 women, 26 men) were operated for abdominal hydatid disease between June 1949 and December 1995. The patients ranged in age from 15 to 81 years (median 49 years). In 69 cases only the liver was affected; two patients had concomitant extrahepatic disease (one spleen, one spleen and lung), and 3 had cysts in the spleen only. Cysts were multiple in 11 patients and calcified in 24. Conservative surgical procedures were used for 22 cysts in 20 patients [open partial (n = 3), open total (n = 6), closed total cystectomy (n = 9), marsupialization (n = 2), drainage (n = 2)] and radical surgical procedures for 72 cysts in 54 patients [pericystectomy (n = 41), wedge liver resection or hemihepatectomy (n = 25), splenectomy (n = 5), radical resection of a lung cyst (n = 1)]. Altogether 37 patients (50%) were given perioperative antihelmintic chemotherapy with mebendazole (18 patients) or albendazole (19 patients). Operative mortality rates were 5.0% after conservative surgery and 1.8% after radical surgery. Morbidity rates were 25.0% following conservative surgery and 24.1% following radical surgery. Antihelmintic therapy was well tolerated by all but five patients. All side effects were entirely reversible. Among the 74 patients, 60 (81.0%) were available for long-term follow-up (median 7.2 years; range 2.0-47.0 years). Recurrence of disease was seen in 9 of 60 patients at an interval of 3 months to 20 years from the first operation. The rate of recurrence was significantly lower after radical surgical procedures (p = 0.03) and after closed removal of the cyst (p = 0.04).

1. OLT ist bei Lebermetastasen im Lausanne-Stadium III anderen Therapieverfahren (systemischer und lokoregionarer Chemotherapie) uberlegen. 2. Trotz nachgewiesenem Rezidiv besteht eine gute Lebensqualitat (palliativer Effekt). 3. Das synchrone Auftreten von hamatogenen Lebermetastasen stellt ein mogliches klinisches Selektionskriterium fur das Langzeituberleden dar. 4. Bedeutung einer zusatzlichen Chemotherapie unklar und weitere Sekektionskriterien zur Verbesserung der PUZ notwendig. 5. Bei neuroendokrinen Tumoren OLT bei nicht Ansprechen anderer Therapieverfahren (Embolisation, Hormon- und Immuntherapie) und bei Ausschlus extrahepataler Manifestation sinnvoll. 6. OLT ist bei nichtresezierbaren Lebermetastasen unter dem Aspekt des bestehenden Organmangels als allgemeine Therapieempfehlung abzulehnen und die Indikation im Einzelfall zu diskutieren.