Hydatid cyst disease remains a real health problem in many parts of the world. Surgery remains the mainstay of treatment of liver hydatid disease. Laparoscopic hydatid surgery (LHS) is gaining acceptance all over the world with promising early results.
To present our experience of laparoscopic management of liver hydatid disease in our locality.
PATIENTS AND METHODS:
All patients presented with liver hydatid disease to our department in Al-Jumhori Teaching Hospital were planned to undergo laparoscopic hydatid surgery (LHS). The diagnosis was made by abdominal ultrasonography and/or computed tomography. Surgical treatment was decided for cysts larger than 4 cm. Exclusions from laparoscopic intervention were for patients with; multiple cysts (>3 cysts), complicated cysts, cysts at risky site, recurrent hydatid, and those who refused the laparoscopic approach.
From Sep 2001 to Jan 2013, 70 patients with hydatid liver disease were presented for surgical treatment. LHS was performed in 46 patients; 15 were males and 31 were females. Their mean age was 35 years (SD±14). In 31 cases the cysts were in the right lobe, in 5 cases were in the left lobe and in 8 cases were in both lobes of liver. In one patient, there were 2 cysts in liver and one cyst in spleen. In 9 patients (19%) the operation was converted to open surgery. The mean operative time was 75 minutes (range, 40 – 120 minutes). The mean length of hospital stay was 3 days (range, 3-8 days). Pus collection in the residual cavity was occurred in two patients, who were managed by laparotomy and drainage. Recurrence was detected in one patient 10 years after the LHS (2.3%). There was no mortality.
This study highlighted that laparoscopic approach for hepatic hydatid surgery is a safe and effective method in selected patients.