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Laparoscopic Treatment in Children with Hydatid Cyst of the Liver
Sergey V Minaev1, Igor N Gerasimenko2, Igor V Kirgizov3
1Department of Pediatric Surgery, Stavropol State Medical University, 310 Mira Str., Stavropol, Russian Federation, 355017. sminaev@yandex.ru.
Insights
Laparoscopic surgery for pediatric liver hydatid cysts (HCL) is safe and effective. This minimally invasive approach offers shorter operation times and fewer complications compared to open surgery for HCL treatment.
Area of Science:
- Pediatric Surgery
- Hepatobiliary Surgery
- Minimally Invasive Surgery
Background:
- Surgical management of pediatric liver hydatid cyst (HCL) lacks a definitive consensus.
- This study compares laparoscopic and open surgical outcomes for childhood HCL.
Purpose of the Study:
- To evaluate and compare the outcomes of laparoscopic versus open surgery for treating hydatid cysts in children's livers.
- To determine the safety and efficacy of each surgical approach.
Main Methods:
- Retrospective analysis of 81 pediatric patients with HCL, divided into a laparoscopy group (n=21) and an open surgery group (n=60).
- Data collected included clinical assessments, surgical duration, complications, and postoperative outcomes.
- Cyst types (Gharbi/WHO-IWGE classification) and locations were documented.
Main Results:
- Laparoscopic surgery resulted in significantly shorter hospital stays (5.6 days vs. 12.1 days) and operation times (90.1 min vs. 120.6 min).
- Local complication rates were comparable, with 14.3% in the laparoscopy group and 21.6% in the open surgery group.
- No systemic complications were observed in either group.
Conclusions:
- Laparoscopic surgery for pediatric HCL is a safe and viable option, adhering to established surgical principles.
- The laparoscopic technique demonstrates advantages in reduced surgical duration and fewer postoperative complications.
- This approach offers a promising alternative for managing liver hydatid cysts in children.
Background:
There is no consensus on the surgical treatment of children with hydatid cyst of the liver (HCL). We evaluated the outcomes of laparoscopic and open surgery for childhood HCL.
Methods:
We performed 81 open surgery and laparoscopic procedures in 37 (45.7%) boys and 44 (54.3%) girls with HCL (mean age 9.3 ± 2.1 years) who were assigned to a main group (laparoscopy, n = 21) and a control group (open surgery, n = 60). Clinical assessments, surgical durations, complications, and postoperative outcomes were investigated. Cyst types in the two groups were I (Gharbi)/CE 1 (WHO-IWGE), 71.4 and 58.3%, respectively; II/CE 2, 19.1 and 25.0%, respectively; and III/CE 3, 9.5 and 16.7%, respectively. The parasitic hydatid cysts were located mostly in the right liver lobe in both the main and control groups (90.4 and 80.0%, respectively).
Results:
Hospital stays were significantly (p < 0.05) longer in patients in the control group (12.1 ± 1.5 vs. 5.6 ± 2.2 days). Operation time was significantly (p < 0.01) shorter for the main group (90.1 ± 7.8 vs. 120.6 ± 5.3 min). Local complications (residual cavity infection, biliary fistula) occurred in 21.6% of patients in the control group and 14.3% in the main group. Each was treated, and none recurred. There were no apparent systemic complications.
Conclusions:
Laparoscopic surgical treatment for children with HCL is safe in compliance with all classic open surgery principles. The laparoscopic technique offered a shorter duration of the surgical effects and markedly fewer postoperative complications.
