Open or laparoscopic treatment for hydatid disease of the liver? A 10-year single-institution experience

Abstract

BackgroundSelection of the most appropriate treatment to obtain the lowest morbidity, mortality, and recurrence rates is mandatory for hydatid disease of the liver. This study evaluated the results of laparoscopic treatment (compared with the open approach) in the context of a 10-year single-institution experience.MethodsBetween January 1998 and January 2008, 333 patients with hydatid disease of the liver underwent surgery in the authors’ department. Only the following aspects were considered as selection criteria for laparoscopic surgery: liver cyst not located in segment 1 or 7, with corticalization on the surface and no evidence of intrabiliary rupture. Of 62 patients who underwent laparoscopic treatment, 3 required conversion to open surgery. The remaining 59 patients (group 1) were analyzed. During the same period, 271 patients with hepatic hydatid disease underwent conventional surgery, but only 172 records were compatible with the criteria for the laparoscopic approach and the respective patients were retrospectively reviewed (group 2).ResultsConversion to open surgery occurred in three cases (4.84 %). The mean cyst diameter was 6.62 cm (range, 2–15 cm) in group 1 and 7.23 cm (range, 2–18 cm) in group 2 (p = 0.699). The mean operative time was 72 min (range, 45–140 min) in group 1 and 65 min (range, 35–120 min) in group 2 (p < 0.001). The general complication rate and abdominal wound complication rate were respectively 0 % and 0 % in group 1 (p = 0.023) compared with 5.23 and 8.72 % in group 2 (p = 0.015). The mean hospital stay was 6.42 days (range, 1–21 days) in group 1 and 11.7 days (range, 4–80 days) in group 2 (p < 0.001). The mean follow-up period was 24.2 months (range, 6–32 months) in group 1 and 28.4 months (range, 6–40 months) in group 2. No recurrences were observed in either group during this period.ConclusionLaparoscopic surgery provides a safe and efficacious approach for almost all types of hepatic hydatid cysts. Large, prospective, randomized trials are needed to confirm its superiority.

Laparoscopic Versus Conventional Surgery for Hepatic Hydatid Disease: A Comparative Study

“…The cause for more time in case of laparoscopic group was our initial experience with the procedure. Other studies had comparable results (7,13). Hospital stay in our study, in laparoscopic group was 3.40 days while as in open group it was 8.73 days, which was in concordance with other studies (5,14) In our study, mean time to return to work was 8.10 days and for open group it was 20.70 days.…”

Experience of Management of Liver Hydatid Disease in a Tertiary Care Hospital– Comparison of Surgical Techniques

“…(10) Very few series are available which compare the results of open versus laparoscopic surgery, hence our series has been a learning experience towards a comparative analysis. The largest published series of 59 patients by Florin Zaharie et al (2013). (11) has also confirmed the efficacy of laparoscopy over open surgery in the management of hepatic hydatid disease.…”

“…The largest published series of 59 patients by Florin Zaharie et al (2013). (11) has also confirmed the efficacy of laparoscopy over open surgery in the management of hepatic hydatid disease. The other large series comprise of open surgical management of 391 patients by Heikal Bedioui et al (2012).…”

“…Intraoperative spillage (13.3%) and iatrogenic liver injury (6.7%) (14,11) The encouraging results favouring laparoscopic surgery namely significantly lower postoperative morbidity, shorter hospital stay and rapid healing, should motivate enhanced use of laparoscopy as a prime approach towards liver hydatidosis. The only limitations are thorough preoperative evaluation of relation of cysts with biliary tree and avoiding patients with cyst in laparoscopic inaccessible segments (I, II, VII).…”

Laparoscopic endocystectomy in patients with liver echinococcosis

“…Данная методика при адек-ватном её применении сочетает в себе пре-имущества малоинвазивных вмешательств и возможность применения различной опе-ративной техники -от резекции органа до ушивания остаточных полостей [5]. Однако данная методика не лишена недостатков и нерешённых проблем [6]. Одно из главных препятствий к широкому внедрению лапаро-скопической техники в хирургию эхинокок-коза печени -боязнь разлива гидатидной жидкости при эвакуации содержимого ки-сты с развитием рецидива и/или анафилак-тической реакции [5].…”