Feasibility and safety of laparoscopic management of hydatid disease of the liver.
OBJECTIVE
Laparoscopic treatment of hydatid disease of the liver produces encouraging results, though its feasibility and safety have been questioned. We evaluated the feasibility and safety of laparoscopic management of hydatid disease of the liver.


METHODS
Consecutive patients with this disease reporting to our department from August 1998 to January 2002 were offered laparoscopic management. Our protocol included preoperative albendazole for 4 weeks, laparoscopic cyst evacuation after its sterilization, and deroofing and suction drainage of the cavity, addition of omentoplasty if required, and a follow-up exceeding 6 months.


RESULTS
Eighteen patients (M11:F7) with 22 liver hydatid cysts underwent laparoscopic surgery. The mean cyst size was 7.4 cm (range, 5.6 cm to 16.6 cm). Two patients needed conversion to an open operation. Spillage of cyst contents occurred in 5 patients. True recurrence of hydatid disease occurred in the original site in 2 patients (11%), and false recurrence was seen in 2 patients (11%), all within 6 months.


CONCLUSIONS
With proper patient selection, laparoscopic management of hydatid cysts of the liver is a feasible option with low rates of conversion. Both true and false recurrences are common with conservative laparoscopic options, and undetected ectocysts may be the cause of true cyst recurrence.
Baskaran
Vasudevan
V
Department of Gastrointestinal Surgery, Army Hospital R&R, Delhi Cantt, New Delhi, India. baskaran_vasu@hotmail.com
Patnaik
Pradeep Kumar
PK
D015766:Albendazole / Q000627:therapeutic use; D000923:Anticestodal Agents / Q000627:therapeutic use; D004322:Drainage / Q000379:methods; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome
D000923:Anticestodal Agents; D015766:Albendazole