Minimally invasive treatment of hepatic hydatid cysts

Hydatid cyst is a parasitosis caused by Taenia Echinococcus. In the last 10 years, new methods of treatment of the hydatid cyst have been proposed (percutaneous or laparoscopic).

This retrospective study includes 24 patients with hepatic hydatid cyst (HHC) who were treated by a minimally invasive approach, 18 women and 6 men (average age 49.3 years), representing 10% of all patients with HHC.

The average operative time was shortened to about 70 minutes. The conversion rate was 25%. In all cases managed laparoscopically, the prophylactic flooding of the peritoneal cavity was realized with peroxide solution 10 per thousand or with hypertonic saline 30%. The inactivation of the cyst was performed with hypertonic saline in most of the cases. Most cysts were univesicular (62.5%), but there were also multivesicular cysts (37.5%). In two cases patients presented hepatic and pulmonary hydatid disease which were also approached in a minimally invasive manner. The average postoperative period of the cases treated laparoscopically was 6 days and for the converted cases it was 13.3 days.

The open surgical approach of HHC is highly expensive due to the postoperative period, therefore a laparoscopic approach may be advocated. The minimally invasive method shortens the postoperative hospitalization period, reduces the number of complications as well as the overall costs and facilitates a rapid social reintegration. All these arguments recommend the laparoscopic approach as a standard procedure for hepatic hydatid disease.