[Extraperitoneal transomphalic drainage of the posthydatid hepatic restant cavity by coelioscopic approach]

Being often biliary contaminated and suppurative, the hydatid hepatic cyst is in fact a real parasitic abscess. So far its surgical approach represents the only credible possibility of treatment. Authors impart their experience regarding the external drainage of the restant posthydatid cavity, by using a completely extraperitoneal way of bringing out the drain, by means of the round ligament, an original method conceived and put into practice by Prof. D. Burlui in 1968. This technique is simple, without risks or complications, possible for most of the parasite hepatic locations, especially for the central segments, for which this method is superior to other surgical procedures. The greatest advantage of the extraperitoneal transomphalic route of the drain is the absence of the peritoneal losses and so the impossibility of biliary leakage occurrence. The radiological and the ultrasonic controls confirm the reduction and finally total fibrosis and disappearance of the remaining cavity, about two months after the surgery. In this moment the drainage may be suppressed. In December 2001, we added to this method an other original variant: the coelioscopic approach of the extraperitoneal transomphalic drainage of the restant posthydatid cavity, representing the aim of this paper.