Laparoscopic surgery in hepatic hydatid cysts: a technical improvement

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Parasitic Diseases

Background:

• Hepatic hydatid cysts pose a significant surgical challenge, particularly in tropical regions like India.
• Traditional open surgical excision has been the primary treatment modality.
• The advent of laparoscopy introduced a less invasive surgical option.

Purpose of the Study:

• To evaluate the efficacy and safety of laparoscopic management for large hepatic hydatid cysts.
• To assess the feasibility of achieving complete cyst evacuation and excision using videoendoscopic techniques.
• To determine the postoperative outcomes and recurrence rates associated with laparoscopic hydatid cyst surgery.

Main Methods:

• Six patients with large hepatic hydatid cysts underwent laparoscopic management.
• Preoperative treatment included albendazole therapy for over two months.
• The procedure involved complete cyst content evacuation and subtotal excision of the cyst wall, with careful trocar placement to prevent spillage.
• Saucerized cavities were drained, with drains removed post-ultrasound confirmation.

Main Results:

• Successful management of six cases of large hepatic hydatid cysts using laparoscopy.
• Complete evacuation and excision were achieved without intra-abdominal spillage.
• Postoperative follow-up ranging from 3 to 9 months showed no evidence of recurrence.
• Drain removal occurred between 6 and 9.4 days post-surgery.

Conclusions:

• Laparoscopic management of hepatic hydatid cysts is a viable and safe alternative to open surgery.
• Careful surgical technique, including trocar placement, can prevent spillage and maintain surgical principles.
• This minimally invasive approach yields excellent short-term outcomes and no recurrence in the studied cohort.