{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:50:03Z","timestamp":1791593403855,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T00:00:00Z","timestamp":1754179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T00:00:00Z","timestamp":1754179200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The main objective was to compare the results of conservative surgery (CS) and radical surgery (RS)\u2014defined as complete removal of all layers of the cyst\u2014for the treatment of liver cystic echinococcosis (LCE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent surgery at our institution for LCE between 1996 and 2021 were retrospectively analyzed using a prospective registry. A comparative analysis between groups was performed, focusing on the evaluation of potential risk factors for hepatic recurrence (HR) and complex biliary fistula (BF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 192 surgeries included, 66% underwent RS. Groups were homogeneous except for cyst diameter and contact with the inferior vena cava, hepatic vein, or diaphragm. CS was associated with a higher incidence of complex BF (16.9% vs. 6.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02) and longer hospital stay (18 vs. 10.3\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). Multivariate analysis showed that a residual pericyst layer in contact with portal pedicle was the main risk factor for complex BF (OR 21.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.009). HR occurred more often in the CS group (15.6% vs. 1.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Independent risks factors for HR included cyst diameter \u2265\u00a010\u00a0cm, coexistent extrahepatic cysts, and residual pericyst layer \u2265\u00a040%. Disease\u2010free survival at 1, 3, and 5\u00a0years remained stable at each time point in the RS group (97.5%) but decreased with time in the CS group (94.5%, 67.4%, and 60.7%\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although surgery for LCE should be individualized, RS is preferable in cases with preoperative risk factors as it is associated with lower incidences of complex BF and HR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70026","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T03:19:28Z","timestamp":1754277568000},"page":"2409-2418","source":"Crossref","is-referenced-by-count":2,"title":["Surgery for Liver Cystic Echinococcosis: Risk Factors Related to the Risk of Complex Biliary Fistula and Hepatic Recurrence. Results of a Long\u2010Term Cohort Study"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4985-9970","authenticated-orcid":false,"given":"Marina","family":"Vila\u2010Tura","sequence":"first","affiliation":[{"name":"Hepato\u2010Biliary Surgery and Liver Transplantation Unit Department of Surgery Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Ramos","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary Surgery and Liver Transplantation Unit Department of Surgery Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Leiva","sequence":"additional","affiliation":[{"name":"Department of Radiology Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristel","family":"Mils","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary Surgery and Liver Transplantation Unit Department of Surgery Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina","family":"L\u00f3pez\u2010Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary Surgery and Liver Transplantation Unit Department of Surgery Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriana","family":"Barrios","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary Surgery and Liver Transplantation Unit Department of Surgery Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Llad\u00f3","sequence":"additional","affiliation":[{"name":"Hepato\u2010Biliary Surgery and Liver Transplantation Unit Department of Surgery Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2009.11.001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/ales.2019.08.01"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.12.014"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.10.029"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010007\u20100301\u20101"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gassur.2005.10.013"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.11.012"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008519"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010015\u20102970\u20105"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010010\u20101220\u20100"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009370"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101694\u20105552"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13244\u2010022\u201001190\u2010y"},{"issue":"5","key":"e_1_2_11_15_1","first-page":"7039","article-title":"Efficacy of Radical and Conservative Surgery for Hepatic Cystic Echinococcosis: A Meta\u2010Analysis","volume":"8","author":"He Y. 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