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April 19, 2026
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June 1, 2026
Published
June 12, 2026
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Abstract

Background: Hydatid disease caused by Echinococcus granulosus is endemic in Iraq and the Middle East. Surgery remains the definitive treatment for liver hydatid cysts, and the choice of scolicidal agent is critical to minimising intraoperative spillage complications and postoperative morbidity. Povidone-iodine and hypertonic saline are the most widely used scolicidal agents, yet their comparative efficacy and safety in clinical practice require further evaluation.


Objectives: To evaluate the effectiveness and safety of 10% povidone-iodine compared with 15–20% hypertonic saline as a scolicidal agent in the surgical management of liver hydatid cysts, with respect to postoperative complications and recurrence rate.


Patients and Methods: A prospective single-centre study including 110 patients with liver hydatidosis managed surgically at Al-Nasiriyah Teaching Hospital and Al-Hussain Teaching Hospital, Nasiriyah, Iraq, from January 2022 to December 2024. Patients were divided into two groups: Group A (povidone-iodine, n=91) and Group B (hypertonic saline, n=19). All patients were followed up for up to 24 months with ultrasonography and CT, liver enzyme assays, and clinical assessment for wound infection, collection, and abscess formation.


Results: The mean age was 33.24±13.96 years and 65.45% were female. Laparoscopic surgery was performed in 63.64% of patients. The overall recurrence rate was 12.73%. Elevated liver enzymes (9.89% vs. 42.11%, p<0.001), wound infection (8.79% vs. 26.32%, p=0.031), fluid collection (10.99% vs. 31.58%, p=0.021), and abscess formation (4.40% vs. 21.05%, p=0.029) were all significantly less frequent in the povidone-iodine group. No significant differences were found between groups in hospital stay (p=0.567) or recurrence rate (p=0.752). Prolonged hospital stay was the only factor significantly associated with recurrence (p=0.001).


Conclusions: Povidone-iodine (10%) is superior to hypertonic saline as a scolicidal agent in reducing liver enzyme elevation, wound infection, fluid collection, and abscess formation following liver hydatid cyst surgery. Both agents have comparable hospital stay and recurrence rates.

Keywords

hydatid cyst liver scolicidal agent povidone-iodine hypertonic saline Echinococcus granulosus laparoscopic surgery

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Copyright (c) 2026 Ahmed Ali Ismael, Abdul-Hussein Segeel Ashour Al-Jaberi (Author)

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Ahmed Ali Ismael and Abdul-Hussein Segeel Ashour Al-Jaberi (2026) “Povidone-Iodine as a Scolicidal Agent in Liver Hydatid Cyst Surgery: A Prospective Comparative Study with Hypertonic Saline”, Journal of Biomedicine and Biochemistry, 5(2), pp. 24–33. doi:10.57238/jbb.2026.7432.1168.
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Ahmed Ali Ismael and Abdul-Hussein Segeel Ashour Al-Jaberi (2026) “Povidone-Iodine as a Scolicidal Agent in Liver Hydatid Cyst Surgery: A Prospective Comparative Study with Hypertonic Saline”, Journal of Biomedicine and Biochemistry, 5(2), pp. 24–33. doi:10.57238/jbb.2026.7432.1168.
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