Laparoscopic treatment of hepatic hydatid cyst

Abstract

Objective: To determine the outcome of laparoscopic management of hepatic hydatid disease in terms of complications.

Study design: Case series.

Place and duration of study: Surgical C Unit, Khyber Teaching Hospital, Peshawar, from February 2007 to March 2010.

Methodology: All patients with 3 or less hepatic hydatid cysts who underwent laparoscopic treatment for hepatic hydatid cyst disease were included during the study period. Laparoscopic aspiration, unroofing and evacuation of the hepatic hydatid cysts was done. Clinicopathologic features, operative time, conversion to laparotomy, morbidity, mortality and recurrence rates were analysed.

Results: Forty three patients had laparoscopic treatment for hepatic hydatid cysts. Females were 27 (62.79%) and males were 16 (37.20%). Mean age of patients was 38.6 ± 14.03 years (range 15-64 years). Pain was the commonest presentation occurring in 34 (79.06%) and mass in 9 (20.93%). Hepatic hydatid cysts were successfully treated laparoscopically in 40 patients. Open surgery conversion was needed in 3 (6.97%) due to inadequate access. The mean duration of surgery was 46.27 ± 13.84 minutes. Complications included port-site infection in 3 (6.97%), bile leak in 4 (9.30%) and recurrence in 2 (4.65%) cases; there was no mortality in the series.

Conclusion: Laparoscopic hepatic hydatid cyst surgery was a safe and effective method in selected patients.