Radical laparoscopic treatment for liver hydatidosis

Abstract

Background: There is no scientific evidence to show which surgical technique should be used in treating hydatidosis of the liver; nor is there consensus on whether laparoscopy should be used in hydatidosis, because of the risk of dissemination or anaphylaxis.

Materials: We conducted a multicenter study of laparoscopic radical surgery for hydatidosis of the liver (LRSH). The main objectives of the study were to determine the feasibility of LRSH, to examine the associated morbidity, and to evaluate the associated recurrence rate.

Materials and methods: The present report is based on a retrospective multicenter study of patients with hydatid disease of the liver treated by LRSH. The study period was from January 2000 to April 2012.

Results: There were 37 patients (46 % male) with 43 cysts. The median age was 53.1 years. Median cyst size was 5.8 cm. The most common location of the cyst was the left lateral sector (62 %). The median number of trocars used was 4. Protective scolicide-soaked swabs were used in 57 % of patients. We performed 24 total closed cystectomies, 12 left lateral sectionectomies, and 4 liver resections. The median operating time was 185 min and the mean blood loss was 184 mL. The conversion rate was 8 %. Morbidity was 16 % and mortality 0 %. The length of hospital stay was 4.8 days. No cyst recurrence was observed after a follow-up of 30.6 months.

Conclusions: Despite the limitations and biases of a retrospective multicenter study, we believe that LRSH is feasible in favorable segments but is technically demanding. The low morbidity and absence of recurrence suggest that LRSH should be performed whenever feasible.