Background: Ecchinococcal disease is still a serious problem in certain parts of the world, with liver as the most affected organ. Surgery remains the mainstay of treatment of hydatidosis, but the optimal surgical procedure remains unsettled. Objective: Safety and efficacy of major hepatic resection in multiple and giant hepatic hydatidosis. Patients & Methods: 63 patients had hepatic hydatidosis associated with spleen, lung, and suprarenal hydatidosis were managed by major hepatic resection between April 2005 to April 2011. 43 (68%) males and 20 (32%) females, age range 8 - 56 years. Cysts were found in the liver only in 51 (81%) patients, liver with spleen in 5 (8%), liver, spleen with lung in 2 (3.1%), liver and lung in 4 (6.3%), liver and suprarenal in one patient (1.6%). Results: Multiple cysts were found in 38 (60%) and solitary cyst in 25 (40%) with Cysts diameter ≤5 cmin 22 (35%), 5 - 10 cm in 16 (25%), and 10 - 38 in 25 (40%). Right hepatectomy in 24 (38%), right trisectionectomy in 2 (3.2%), right hepatectomy with Segment III in 4 (6.3%), right hepatectomy with Segment I in 2 (3.2%), left hepatectomy in 12 (19%), left lateral sectionectomy in 6 (9.5%), left hepatectomy with Segment VI in 3 (4.8%), left lateral sectionectomy with right posterior sectionectomy in 2 (3.2%), right hepatectomy with splenectomy in 7 (11%) and right hepatectomy with right suprarenal in one (1.6%) patient were performed. Hospital stay was 4.2 (3 - 13 days) There was one mortality and 12 (19%) morbidities. No recurrence on follow up period (8 - 60 months) was observed. Conclusion: Radical procedure is safe and effective option for hepatic hydatidosis and should be performed when the entire lobe is diffusely involved by huge or multiple hydatidosis with little healthy liver tissue.
 K. M. Harris, D. L. Morris, R. Tudor, P. Toghill and J. D. Hardcastte, “Clinical and Radiological Features of Simple and Hydatid Cysts of the Liver,” British Journal of Surgery, Vol. 73, No. 10, 1986, pp. 835-838. doi:10.1002/bjs.1800731025
 A. Flisser, “Larval Tapeworm Infections; Cysticercosis, Cystic Echinococcosis and Alveolar Echinococcosis,” In: D. J. Richardson and P. J. Krause, Eds., Northamerica Parasitic Zoonoses, Kluwer Academic Publishers, Norwell, 2002, pp. 57-71.
 M. I. El Tahir, M. F. Omojole, T. Malatani, A. H. Alsaigh and O. A. Ogunbiyi, “Hydatid Disease of the Liver; Evaluation of Ultrasound and Computed Tomography,” British Journal of Radiology, Vol. 65, 1992, pp. 390-392. doi:10.1259/0007-1285-65-773-390
 P. Mate Miranda, I. Osnaya Palma, U. Rodriguez Prado, A. Gutierrez Marin, M. Tawil, S. H. Gonzelez, et al., “Epidemiologic and Ultrasonographic Study of Echinococcosis in a Community in the State of Mexico,” American Journal of Tropical Medicine and Hygiene, Vol. 77, No. 3, 2007, pp. 500-503.
 Z. Turkyilmaz, K. Sonmez, R. Karabulut, et al., “Conservative Surgery for Treatment of Hydatid Cysts in Children,” World Journal of Surgery, Vol. 28, No. 6, 2004, pp. 597-601. doi:10.1007/s00268-004-7029-9
 P. K. Chowbey, S. Shah, R. Khullar, et al., “Minimal Access Surgery for Hydatid Cyst Disease: Laparocopic, Thoracoscopic, and Retroperitoneoscopic Approach,” Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 13, No. 3, 2003, pp. 159-165. doi:10.1089/109264203766207672
 S. Saini, P. R. Mueller, J. I. Ferrucci, et al., “Percutaneous Aspiration of Hepatic Cysts Does Not Provide Definitive Therapy,” American Journal of Roentgenology, Vol. 141, No. 3, 1983, pp. 559-560.
 N. C. Armitage and L. H. Blummgarten, “Partial Resection and Fenestration in the Treatment of Polycystic Liver Disease,” British Journal of Surgery, Vol. 71, No. 3, 1984, pp. 242-244. doi:10.1002/bjs.1800710331
 D. Voros, D. Katsarelias, G. Polymoneas, A. Polydorou, L. Pisitiolis, A. Kalovidouris, et al., “Treatment of Hydatid Liver Disease,” Surgical Infections, Vol. 8, No. 6, 2007, pp. 621-627. doi:10.1089/sur.2006.0070
 F. Guiliant, F. D’Acapito, M. Vellone, et al., “Risk for Laparoscopic Fenestration of Liver Cysts,” Surgical Endoscopy and Other Interventional Techniques, Vol. 17, No. 11, 2003, pp. 1735-1738. doi:10.1007/s00464-002-9106-1
 A. M. El shazly, S. E. Awad, M. A. Hegazy, K. A. Mohammad and T. A. Morsy, “Echinococcosis Granulosus Hydatidosis an Endemic Zoonotic Disease in Egypt,” Journal of the Egyptian Society of Parasitology, Vol. 37, No. 2, 2007, pp. 609-622.
 H. M. Salama, N. H. Ahmed, N. Eldeeb and R. Ahmed, “Hepatic Hydatid Cysts: Sonographic Follow up after Percutaneous Sonographically Guided Aspiration,” Journal of Clinical Ultrasound, Vol. 26, No. 9, 1998, pp. 455-460. doi:10.1002/(SICI)1097-0096(199811/12)26:9<455::AID-JCU4>3.0.CO;2-M
 A. Zaouche, K. Haouet, M. Jouini, A. El hachaichi and C. Dziri, “Management of Liver Hydatid Cysts with a Large Biliocyst Fistula: Multicenter Retrospective Study,” World Journal of Surgery, Vol. 25, No. 1, 2001, pp. 28-39. doi:10.1007/s002680020005
 S. Demircis, S. Eraslan, E. Anadol and L. Bozatli, “Comparison in the Results of Different Surgical Techniques in the Management of Hydatid Cysts of the Liver,” World Journal of Surgery, Vol. 13, No. 1, 1989, pp. 88-91. doi:10.1007/BF01671161
 E. Ozaslan and Y. Bayrakter, “Endoscopic Therapy in the Management of Hepatobiliary Hydatid Disease,” Journal of Clinical Gastroenterology, Vol. 35, No. 2, 2002, pp. 160-174. doi:10.1097/00004836-200208000-00009
 H. Simsek, E. Ozaslan, I. Sayek, C. Svas, O. Abasoglu, A. Soylu, et al., “Diagnosis and Therapeutic ERCP in Hepatic Disease,” Gastrointestinal Endosc, Vol. 58, No. 3, 2003, pp. 384-389. doi:10.1067/S0016-5107(03)00013-0
 S. Berrada, B. Essadki and N. Zerouali, “Kyste Hydatique du Foie. Treatment par Resection du Dome Saillant. Notre Experience a Propos d’Une Serie de 495 Cases,” Annales De Chirurgie, Vol. 47, 1993, pp. 510-512.
 C. Kayaalp, B. Bostana, S. Yol and M. Akoglu, “Distribution of Hydatid Cysts into the Liver with Reference to Cystobiliary Communications and Cavity—Related Complications,” American Journal of Surgery, Vol. 185, No. 2, 2003, pp. 175-179. doi:10.1016/S0002-9610(02)01202-3
 A. Alper, O. Ariogul, A. Emre, A. Uras and A. Okten, “Choledochoduodenostomy for Intrabiliary Rupture of Hydatid Cysts of Liver,” British Journal of Surgery, Vol. 74, No. 4, 1987, pp. 243-245. doi:10.1002/bjs.1800740405
 O. Elbir, H. Gundoghu, M. Gagilulekci, C. Kayaalp, F. Atalay, M. Savkilioglu, et al., “Surgical Treatment of Intrabiliary Rupture of Hydatid Cysts of the Liver: Comparison of Choldochoduodenestomy with T-Tube Drainage,” Digestive Surgery, Vol. 18, No. 4, 2001, pp. 289-293. doi:10.1159/000050154
 K. Yorganci and I. Sayek, “Surgical Treatment of Hydatid Cysts of the Liver in the Era of Percutaneous Treatment,” American Journal of Surgery, Vol. 184, No. 1, 2002, pp. 63-69. doi:10.1016/S0002-9610(02)00877-2
 C. S. Ramachandran, D. Goel and V. Arora, “Laparoscopic Surgery in Hepatic Hydatid Cysts: A Technical Improvement,” Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, Vol. 11, No. 1, 2001, pp. 14-18. doi:10.1097/00129689-200102000-00004
 R. Adam, A. Laurent, D. Aizoulay, D. Castaring and H. Bismuth, “Two-Satge Hepatectomy: A Planned Strategy to Treat Irresectable Liver Tumors,” Annals of Surgery, Vol. 232, No. 6, 2000, pp. 777-785. doi:10.1097/00000658-200012000-00006
 S. Demircis, S. Eraslan, E. Anadol and L. Bozatli, “Comparison of the Results of Different Surgical Techniques in the Management of Hydatid Cysts of the Liver,” World Journal of Surgery, Vol. 13, No. 1, 1989, pp. 88-91. doi:10.1007/BF01671161
 P. Magistrelli, R. Masetti, R. Coppola, A. Messia, G. Nuzzo and A. Picciocchi, “Surgical Treatment of Hydatid Disease of the Liver,” Archives of Surgery, Vol. 126, No. 4, 1991, pp. 518-523. doi:10.1001/archsurg.1991.01410280122020
 A. A. Balik, M. Basoglu, F. Celebi, D. Oren, K. Y. Palat, S. S. Atamanalp, et al., “Surgical Treatment of Hydatid Disease of the Liver: Review of 304 Cases,” Archives of Surgery, Vol. 134, No. 2, 1999, pp. 166-169. doi:10.1001/archsurg.134.2.166
 D. D. Karavias, C. E. Vaglanos, N. Bouboulis, et al., “Improved Techniques in the Surgical Treatment of Hepatic Hydatidosis,” Surgery, Gynecology & Obstetrics, Vol. 174, No. 3, 1992, pp. 176-180.
 F. S. Rakas, M. Elmufti, P. M. Mehta, et al., “Omentoplasty or Tube Drainage for the Management of the Residual Cavity Following the Removal of Hepatic Hydatid cysts,” Hepatogastroeneterolgy, Vol. 37, Suppl. 2, 1990, pp. 55-57.
 C. Dziri, J. C. Paquet, J. M. Hay, et al., “Omentoplasty in the Prevention of Deep Abdominal Complications after Surgery for Hydatid Disease of the Liver: A Multicenter Prospective Randomized Trial,” Journal of the American College of Surgeons, Vol. 188, No. 3, 1999, pp. 281-289. doi:10.1016/S1072-7515(98)00286-5