Current approaches in the surgical treatment of liver hydatid disease: single center experience

Abstract

Background Liver hydatid disease is a common benign condition in many countries. Compared to open surgery, laparoscopic treatment can play an important role in improving the post-operative recovery, reducing the morbidity and recurrence rate of these patients.The purpose of this study is to show that the laparoscopic method is effective and safe in the treatment of liver hydatid cysts compared to open surgery, even in large cysts. Methods All consecutive cases surgically managed for liver hydatid cyst from 7 January 2008 and 15 January 2010 in our institution were included in this study.The surgical approach (laparoscopic or open) and operative strategy, as well as operative and prognostic outcomes, were analyzed. Cyst size, type, location, presence of biliary tract communication, radiological findings, duration of hospitalization, recurrence and postoperative morbidity were analysed and compared retrospectively. Results A total of 60 patients were included in the study.A total of 23 patients underwent open surgery, and 37 patients underwent laparoscopic surgery.Operation types of laparoscopic surgery were as follows: partial pericystectomy (12patients), total cystectomy(2 patients), partial pericystectomy+total cystectomy(7patients) and cystectomy(16patients).The surgical procedures chosen for open treatment of the residual cavity were partial pericystectomy and omentoplasty(17cases), total pericystectomy(3cases) and partial and total pericystectomy(3cases).Cysto-biliary communication was found in 9 patients. A total of 10 patients underwent preoperative endoscopic retrograde cholangiography, and one patient underwent postoperative endoscopic retrograde cholangiography.There was a progression of hypernatremia in 1 patient, wound infections in 3 patients, and perioperative hemorrhage in 3 patients. There were no statistically significant differences concerning age( p = 0.344), gender( p = 0.318), ASA classification( p = 0.963), Gharbi classification( p = 0.649) whereas there were significant differences related to cyst location( p = 0.040) and size( p = 0.022) in patients undergoing laparoscopic and open surgery. Postoperative temporary biliary fistulas were observed in 2 patients undergoing open surgery. Patients undergoing laparoscopic surgery had the advantages of shorter hospital stays and operation times, less blood loss, faster recovery, and lower wound infection rates. Recurrences were detected in 2.7% of patients undergoing laparoscopic surgery and 4.7% of those undergoing open procedures. Conclusion Compared to open surgery in the treatment of liver hydatid cysts, we have shown that laparoscopic method can be safely performed even in large cysts and/or cysto-biliary communication.

Clinical Characteristics and Management of the Hydatid Cyst of the Liver: A Study from a Tertiary Care Center in Nepal

“…The major form of surgery performed in our study population was partial pericystectomy. This result is in congruence with a study by Bayrak and Altıntas in which partial pericystectomy, laparoscopic, or open accounted for the significant bulk of surgeries in patients of HCL [ 28 ]. Hazra et al, in their study, found partial pericystectomy to be a tissue-sparing procedure.…”

Laparoscopic Treatment of Hydatid Cyst of Liver: Outcome at Tertiary Care Hospital

“…In the study of Palanivelu C et al [13] 37 patients underwent surgical intervention with a mean duration of surgery as 52 minutes and SSI/Port site infection was in 3% cases. While in the study of Bayrak M et al [15] no case was found with Cavity infection and SSI/Port site infection. In the study of Pradhan S et al [18] overall 26 cases underwent surgery and the SSI/Port site infection was found among 7.7% of cases.…”

“…In the study of Palanivelu C et al [13] the most common outcome measured was biliary fistula/leakage among 13.7% cases. In the study of Bayrak M et al [15] mean duration of Hospital stay was 4.58±3.40 days. In the study of Pradhan S et al [18] the most common outcome measured was Biliary fistula/leakage among 11.5% cases, followed by SSI/Port site infection among 7.7% cases, conversion among 7.7% cases and mean duration of hospital stay was 4.58±3.40 days.…”

“…Similarly Sah SP et al [18] also reported that the mean diameter of the cyst was 9.2±2.72 cm in size. However Bayrak M et al [15] reported that average cyst diameter was 13.6 ± 2.8 cm. This is similar to observation in other studies also (6.7-13 cm) [16].…”

“…However, within nonendemic regions, the individuals of all ages are generally equally affected. The Bayrak M et al[15] also reported average age of patients 43.6 years with age range of 14-88 years. On other hand Samala DS et al…”