Treating experience of laparoscopic surgery for hepatic cystic echinococcosis in children

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Objective To evaluate the safety and application value of laparoscopic surgery for hepatic cystic echinococcosis in children. Methods Clinical data of 15 children with hepatic cystic echinococcosis undergoing laparoscopic surgery in People's Hospital of Xinjiang Uigur Autonomous Region from January 2013 to September 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 10 patients were male and 5 were female, aged 3-12 years with a median age of 8 years. Nine patients were with single hepatic cystic echinococcosis and 6 with multiple hepatic cystic echinococcosis. Laparoscopic resection of the internal and external cysts was performed. The capsular wall was soaked with 10% sodium chloride solution after centesis. The perioperative situation and prognosis of the patients were analyzed. Results All 15 children with hepatic cystic echinococcosis underwent laparoscopic surgery successfully, including 6 cases receiving external cystectomy and 9 external combined with internal cystectomy. The median operation time was 75(55-140) min and the intraoperative blood loss was 6(5-15) ml. Bile leakage occurred in 2 children after operation and was cured by conservative treatments. The length of postoperative hospital stay was 9(5-12) d. Oral albendazole was given to prevent recurrence. During the postoperative 2-9 month follow-up, no recurrence of echinococcosis was observed in the liver and pelvic cavity. Conclusions Laparoscopic surgery is safe and feasible treatment for hepatic cystic echinococcosis in children, which possesses advantages of clear surgical field, minimal invasion, quick postoperative recovery, nice incision and short hospital stay. It has small impact on the school-age children and is more likely to be accepted by parents. Key words: Child; Echinococcosis, hepatic; Laparoscopes