Laparoscopic Approach to Liver Hydatidosis: Initial Experience

Abstract

IntroductionHepatic hydatidosis is a pathology that has a worldwide distribution, and is frequent in some rural areas in Argentina. Surgical treatment still offers the best results. The laparoscopic approach is controversial because of lack of experience with this technique. ObjectiveTo evaluate the feasibility and efficacy of the laparoscopic approach in this pathology and to present the experience obtained in a medical center in Argentina. Materials and methodsWe prospectively evaluated patients with a diagnosis of non complicated hydatidosis, over 15 years of age whose cyst had the following characteristics: unique cyst, size less than 5cm, located in the anterior segments or easy access. Analyzed data were sex, age, cyst localization, treatment, operating time, morbidity and mortality and recurrence. ResultsNine patients were operated using a laparoscopic approach. The cysts were localized in the segments III, IV, V and VI. Six patients were operated with pneumoperitoneum and 3 with a parietal traction device; in all the patients the first approach was a laparoscopic PAIR (punction, aspiration, injection and reaspiration).Seven Mabit-Lagrot procedures were performed and 2 pericystectomies. The operative time was a mean of 89.7min and a hospital stay of 52h. The morbidity was 22.2% and the mortality was 0%. Mean follow-up of 19 months showed no recurrences. ConclusionA higher number of patients and a longer follow-up are necessary to evaluate the efficacy of approach; the laparoscopic approach seems to be safe. Our results coincide with the majority of other publications.