Application of laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis

Abstract

Objective To investigate the safety and feasibility of laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis. Methods Between September 2015 and May 2016, patients with hepatic cystic echinococcosis indicated for surgery were evaluate. Selective hemihepatic inflow inclusion or non-selective hepatic inflow inclusion was adopted to control the bleeding. Laparoscopic multifuctional operative dissector (LPMOD) was applied for liver parenchymal transection. Laparoscopic hepatectomy and cystectomy was applied for hepatic cystic echinococcosis in eight cases, including one case of mesohepatectomy, two cases of right posterior sectionectomy, two cases of right partial hepatectomy, one case of left hepatectomy, one case of left lateral sectionectomy and one case of cystectomy in the left hepatic lobe. Results 8 patients received laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis. Seven cases were performed totally laparoscopically and one case required a conversion. The maximum size of the lesion was 10 cm. Operating time was 150-260 min (mean, 200±35); Blood loss was 100-1 000 ml (313±290). One patient received intraoperative transfusion. Postoperative hospital stay was 6-9 days (mean, 7.6±1.3). One patient developed postoperative pleural effusion that resolved after medical treatment. One patient developed biliary leak in postoperative five days and recovered after drainage for twelve days. No remaining cavity infection, postoperative abdominal bleeding, liver failure occurred. No hospital death occurred. Conclusions Laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis is technically safe and feasible. Key words: Echinococcosis, hepatic; Laparoscopes; Hepatectomy; Cystectomy