Objective To study the therapeutic effects of total cystectomy and internal cyst extirpation for hepatic cystic echinococcosis (HCE).Methods From June 2007 to Mar 2011,118 HCE cases were admitted and underwent surgery including 56 cases treated with internal cyst extirpation,and 62 cases with total cystectomy.Operation time,intraoperative blood loss,postoperative hospital stay,postoperative complications,operative mortality and recurrence rate,re-hospitalization rate,re-operation rate were comparatively studied.Results Compared with internal cyst extirpation patients receiving total cystectomy had less postoperative complications,lower rate of recurrence,re-hospitalization and re-operation,and shorter postoperative hospital stay,although with a longer operation time and more intraoperative blood loss.Conclusions Total cystectomy can reduce postoperative complications,recurrence rate,and shorten postoperative hospital stay.Total cystectomy should be a choice of therapy for the management of HCE.