False about hydatid cyst of liver
High-Yield Explanation
Surgery is still the choice and gold standard therapy for hydatid disease. The abdomen is opened, and the peritoneal cavity is packed with mops . *Fluid from the cyst is aspirated and scolicidal agents(cetrimide, chlorohexidine, alcohol, hypeonic saline(15%-20%), 10% povidone-iodine or H2O2 ) are injected into the cyst cavity (formalin should not be used). Hypeonic saline should be left within the cavity for 15-20 minutes to have effective scolicidal effect. * Detection of cystobiliary communications is very crucial as it may cause caustic sclerosing cholangitis when scolicidal agent like formalin is used. Communicating openings may be single or multiple. Cyst more than 10 cm is likely to have cysto-biliary communications. * Laparoscopic pericystectomy is becoming more popular. Contraindications are a deeply situated cyst, densely adherent cyst, and inaccessible cysts; more than 3 cysts; calcified cysts and cysts in other organs. The main problem with laparoscopic pericystectomy is spillage and difficulty in preventing it. * Liver resection - only occasionally segmental or hemihepatectomy is done. ref: SRB&;S manual of surgery, ed 3, pg no 536