Laparoscopic Management of Hepatic Hydatid Cyst: A Single Institute Based Experience
Shams Ul Bari
Keywords :
Advanced laparoscopic surgery, Diagnostic laparoscopy, Direct trocar entry
Citation Information :
Bari SU. Laparoscopic Management of Hepatic Hydatid Cyst: A Single Institute Based Experience. World J Lap Surg 2024; 17 (1):9-13.
Background: Various modalities of treatment for hydatid cyst of liver include drug therapy, conventional open surgery and laparoscopic surgery. Laparoscopic approach is preferred in view of its minimal invasiveness, short hospital stay, early recovery, and lesser wound-related complications.
Aims and objectives: To study the safety and feasibility of laparoscopic surgery in hydatid disease of liver in selected patients.
Materials and methods: The study entitled, “laparoscopic management of hepatic hydatid cyst—A single institute-based experience” was conducted in the Department of General and Minimal Invasive Surgery SKIMS Medical College Bemina, Srinagar, Kashmir, India from November 2019 to August 2021 with a further follow-up for a period of 1 year from September 2021 to August 2022 and the total number of patient studied was 35. Cysts located in segment 3, 4, 5, 6, and 8, with no evidence of calcifications or infection or major biliary communication were included in the study. Cyst located in segment 1, 2, and 7, cyst located near vascular hilum, deep seated cyst, recurrent cysts, and ruptured hydatid cyst were excluded from the study.
Results: The study included 35 patients which included 17 males and 18 females. Twenty eight (80%) patients had a single univesicular cyst located in right lobe of liver, while as three patients had a cyst in right lobe as well as left lobe. Four patient had two cysts in the right lobe. Deroofing of the cyst with evacuation of contents was done in 23 (65.71%) patients while as partial pericystectomy was done in 12 (34.28%) patients. External tube drainage was done in 19 (54.28%) patients while as omentopexy was done in 16 (45.71%) patients. The average operative time was 89.80 minutes (60–120 minutes). Postoperative biliary leak was seen in three patients, which ceased spontaneously within 7–10 days in two patients. One patient needed ERCP with sphincterotomy. Time for return to work was 8.10 days (6–12 days). One of the patients had recurrence after 18 months.
Conclusion: Laparoscopic hydatid surgery is safe and feasible in selected patients. The main advantage being the lower postoperative morbidity, shorter hospital stay, early return to routine work and low recurrence rate.
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