Laparoscopic Treatment Of Hydatid Cysts Research Articles

Laparoscopic management of hydatid cyst of liver

Background: Hydatic disease is caused by a parasite named Ecchinococcus granulosus. This disease is endemic in Pakistan. The disease mostly affects liver forming cysts. The treatment is mainly surgical which can be performed laparoscopically. This study was thus designed to assess the outcomes of the laparoscopic treatment of hydatid cyst of liver in terms of recovery of patient, complications and recurrence.Subjects and methods: This case series was conducted from March 2015 to December 2020 in Surgical Department of Services Institute of Medical Sciences Lahore. Patients who were planned for laparoscopic surgery for hepatic hydatid cysts (CE2, CE3) were included in the study. Patients who have past history of hepatobiliary surgery, with multiple small cysts or those who has refused for laparoscopic surgery were excluded from study. Demographic data, presenting symptoms, clinicopatholigical findings, duration of surgery, hospital stay and complications were recorded on pre-designed Performa. Results: Total of 42 patients were managed laparoscopically for hydatid liver cyst. The mean age of the patients was 39.42 + 12.04 years. There were 20 (47.62%) male and 22 (52.38%) female patients. Thirty patients (71.43%) were from rural areas. Twenty patients (47.62%) had history of close contacts with dogs or domestic animals. Patients mostly presented with symptoms of pain in right hypochondrium and abdominal mass. Majority of the patients had single hydatid cyst in the liver. Right lobe of the liver was more frequently involved than left lobe. Both lobes were involved in 2 (4.8%) patients. The mean duration of surgery was 76 minutes. No patient developed intra or postoperative anaphylactic shock. Biliary leakage was seen in 4 (9.5%), port site infection in 2 (4.8%) patients and conversion to laparotomy was done in 2 patients (4.8%). The mean hospital stay of patients was 3.41+ 2.82 days. There was no mortality of the patients or recurrence of cyst on 12 week follow up.Conclusion: Laparoscopic surgery for hepatic hydatid cyst is safe and effectual treatment in carefully selected patients. It is a simple technique with lesser postoperative morbidity and potentially decreased risk of complications especially recurrence of disease.

Laparoscopic Treatment of Hydatid Cyst of Liver: Outcome at Tertiary Care Hospital

Objective: To determine the outcome of laparoscopic treatment of hydatid cyst of liver at tertiary care Hospital.
 Methodology: This cross sectional, study was conducted at public and private sector Hospitals of Jamshoro/Hyderabad from June 2017 to Sept 2019. It includes all diagnosed patients of Hydatid cyst of liver with either of gender and age range from 15 to 65 years who were operated laparoscopically. Patient’s demographic information, postoperative complications, operative time and hospital stay were recorded via self-made proforma and data was analyzed by using SPSS version 20.
 Results: Total 29 patients were admitted with hydatid disease of liver and out of them 21 patients underwent laparoscopic treatment during study period; their mean age was 46.7±13 years. Males were commonest 71.42% and 28.57% were female. Mean operative time was 98.3±18 minutes. According to postoperative pain, the average of visual analog score was 07.85±1.38 at 24 hours and 3.42±1.50 at 72 hours. VAS mean was 07.8 and 3.4 respectively. Cavity related infection was noticed in 3 cases; port site infection in two cases, bile leak in two and residual cyst was also found in two patients. Mean postoperative Hospital stay was 6.6 days.
 Conclusion: Laparoscopic surgery for hepatic hydatid disease can be conducted safely as it provides advantages of minimal invasive surgery. Careful selection of the patient is utmost important to achieve good results especially in initial phases.

The Comparison of 2 New Promising Weapons for the Treatment of Hydatid Cyst Disease: PAIR and Laparoscopic Therapy.

To compare the effectiveness and safety for hydatid disease treatment, the 2 new minimally invasive therapies: laparoscopic and PAIR (puncture, aspiration, injection, and reaspiration) were compared by systematic meta-analysis. A comprehensive analysis of published cases from 1990 to 2014 was performed using PubMed database. A total of 231 publications on laparoscopic treatment of hydatid cysts and 298 publications on the PAIR treatment were identified. Thirty-eight studies involved 1230 laparoscope-treated subjects and 41 involved 2686 PAIR-treated subjects in this review. The effectiveness and safety of emphasis is placed on the recurrence, insufficient response, death, cure, and postoperative complications. Operation time and hospital stay are also discussed as new evaluation index. The stages of cyst are summarized to determine which stage is suitable for PAIR. Clinical and parasitological cure occurred in 98.7% of patients undergoing laparoscopic intervention and in 97.5% of patients receiving PAIR plus chemotherapy (P<0.014). Recurrence occurred in 1.0% and 1.6%, respectively (P<0.087). Insufficient response occurred in 0.16% and 0.9%, respectively (P<0.009); 2 patients died in each group (P<0.594). Allergic reaction/urticarial/anaphylactic shock occurs in 0.14% and 4.24% of patients receiving laparoscopic intervention and PAIR plus chemotherapy, respectively (P<0.001). Infection/abscess (5.37% and 2.57%; P<0.001) and surgical-related complications (7.32% and 3.43%; P<0.001) were seen more frequently in laparoscopic intervention subjects than PAIR plus chemotherapy subjects. Laparoscopic therapy and PAIR intervention are shown to be safe and effective alternative for open surgery with suitable indication such as cyst type and location. They have different postoperative complication features. The biliary fistula/bile leakage was more frequent in laparoscopic intervention (P<0.001) and fever occurred more in PAIR plus chemotherapy patients.

How to build a simple and safe laparoscopic hydatid evaluation system.

Background:One of the most common problems faced in laparoscopic treatment of hydatid cysts is the difficulty in evacuating the particulate contents (daughter cysts and laminated membrane). Although various instruments and laparoscopic techniques have been described to evacuate the contents of hydatid cysts, most are not available at many surgical centers.Methods:By assembling disposable, cheap, and available anesthesia equipment with common laparoscopic instruments, a laparoscopic system was made to evacuate the contents of a hydatid cyst. Ten patients with hepatic hydatid disease underwent laparoscopic surgery using this new hydatid system between June 2011 and January 2013.Results:The procedure was completely straightforward. Twelve hydatid cysts (2 patients had 2 separated cysts) were evacuated without any spillage. All patients were followed for at least 8 months, with no evidence of recurrence.Conclusions:This simple apparatus, which can be assembled anywhere, was safely used to evacuate the contents of hydatid cysts without causing any spillage.

Laparoscopic Treatment of Hepatic Hydatid Disease

The rapid development of laparoscopic techniques revolutionized the optimum surgical intervention in Echinococcus granulosus disease. The procedure was shown to be feasible and safe, offering the advantages of laparoscopic surgery. Sience the first report on the long-term follow-up of this operation in a large group of patients.1Background: Echinococcal disease is still a serious health problem in certain parts of the world.In the human being the liver is the most frequent organ affected. The natural history of liver hydatidosis in humans till now is poorly understood and Different morphological appearances was observed.2Over recent decades, various reports have been published comparing standard surgical and more conservative modalities for the treatment of the disease. Although Hand-assisted laparoscopic surgery (HALS) has been proposed as a useful alternative to conventional open orlaparoscopic surgery and seems tobe a promising technique in laparoscopic treatment of hydatid cyst which has been applied with successas well as with a wide range of digestive tract�related surgical procedures.3 Gasless laparoscopy also had been introduced in the treatment of liver hydrated and has the advantage of permitting the use of conventional instruments during minimally invasive procedures with a promising results. With many advantages regarding technique.4Aims and objectives: Many review articles was written all over theworlds regarding precautions, accessibility, operative risks, remotesatisfaction in operative results and duration of free disease followingprolonged regular follow-up.The aims of this study was to compare the effectiveness andsafety of laparoscopic intervention and conventional open surgerythat practiced decades of years ago and regarded as standard modalitytreatment of hepatic Echinococcus granulosus disease. The followingparameters were evaluated for both laparoscopic and open proceduresmodalities.Methods of patients selection, operative technique, operatingtime, intraoperative and postoperative complications, postoperativepain and amount of pain killers. Time until resumption of diet, postoperativemorbidity, hospital stay, cost effectiveness, and qualityof life analyses.Material and methods: A literature search was performed using Medlineand the search engine Google, Springer link and Highwire press. Thefollowing search terms used: laparoscopic management of liver hydatidcysts Echinococcus granulosus. There were over thousand of literaturesand papers published discussing this subject. Most recent (2000-2008) and universally widely accepted and recognized was selected.The selected papers were screened for further references. criteria forselection of literatures were the number of cases (more than 50 cases).Methods of analyses whether statistical or nonoperative proceduresonly universally accepted chosen and the institution where the studywas done in specialized institutions for laparoscopic surgery.During this study we observed that patient response to surgicaltrauma, hospital hostility, rapid turn over of hospital beds, costeffectiveness, less morbidity, no mortality, early resuming normalusual activity, minimal postoperative complication, reduced operativetime, early recovery from general anesthesia, decreasing risk of surgery,access to certain locations difficult to be approached in open surgeryall these parameters are better in minimally access surgery than inopen conventional surgery.

Laparoscopic treatment of hydatid cyst of the liver in children. A report on 34 cases

Purpose This study evaluated the safety and efficiency of laparoscopically treated liver cysts in children. Methods From September 2001 to July 2004, 34 patients underwent laparoscopic treatment of hydatid cysts of the liver. All patients had chest x-ray, abdominal sonography, and hydatid serology. The different stages of the procedure were the same as in open surgery: puncture, aspiration, injection of scolicidal agent, reaspiration, removal of proligerous membrane, and resection of the dome. Results The patients' mean average age was 7 years and 7 months (range, 3-14 years). The number of cysts ranged from 1 to 10 with a diameter of 40 to 150 mm (mean diameter, 65.5 mm). One case had a mesenteric associated hydatid cyst, another splenic hydatid cyst. The average length of hospital stay was 5 days (range, 4-14 days). No per- or postoperative complications were reported. At 12 to 45 months follow-up, no recurrence has been reported. Conclusion Laparoscopy represents an excellent approach for the treatment of hydatid cyst of the liver in children.

A new instrument, the "Perfore-Aspirator" for laparoscopic treatment of hydatid cysts of the liver.

The authors introduce a new instrument functioning as both perforator and aspirator in the laparoscopic management of hepatic hydatid cysts. Between January 1998 and January 2002, 11 laparoscopic cystotomy + partial cystectomy + drainage procedures were performed for eight consecutive patients. Eight of the cysts were located in the right lobe, and the remaining three in the left. The average diameter (+/-SD) of the cysts was 9.6 +/- 3.66 cm, and the mean age of the patients was 31.3 +/- 7.24 years. The diagnosis was confirmed by ultrasonography and/or computerized tomography. The procedure was performed with the help of three ports. The "perfore-aspirator" instrument (Bahadir Tibbi Aletler A. S., Samsun, Turkey) was introduced through the 10-mm trocar at the subcostal area, and the cystotomy procedure was done with success. Then, a partial cystectomy procedure was performed with the use of a grasper and scissors attached to an electrocautery device. The average hospitalization period was 5 +/- 1.69 days. No major morbidity or mortality was seen. All patients were treated with albendazole preoperatively and postoperatively.

Laparoscopic treatment of hydatid cysts of the liver and spleen

The short-term results from laparoscopic treatment of hydatid cysts of the liver and spleen were reported previously. The procedure was shown to be feasible and safe, offering the advantages of laparoscopic surgery. This is the first report on the long-term follow-up of this operation in a large group of patients. In this study, 108 hydatid cysts of the liver and spleen in 83 consecutive patients (43 males [52%] and 40 females [48%]) were approached laparoscopically. The mean age of the patients was 40 years (range, 13-85 years). There were 104 liver cysts and 4 spleen cysts. The liver cysts were located in the right lobe in 42 patients (53%), in the left lobe in 21 patients (26%) and in both lobes in 16 patients (21%). Of the 104 cysts, 44 (42%) were uniloculated and 60 (58%) were multiloculated. All cysts were approached laparoscopically. The mean operative time was 80 min (range, 40-180 min). The conversion rate was 3%. The mean hospital stay was 3 days (range, 2-7 days). There were no mortalities, and complications occurred in nine patients (11%). All were managed conservatively except one patient in whom a laparotomy was needed. All patients were followed up for a mean period of 30 months (range, 4-54 months) with serological testing and ultrasonography if needed. In three patients (3.6%) recurrence of the disease developed. The laparoscopic approach to uncomplicated hydatid cysts of the liver and spleen is a safe and effective option with favorable long-term results.

Laparoscopic treatment of hydatid cysts of the liver

We report for the first time treatment of hydatid cyst of the liver laparoscopically. The patient is a 27-year-old man who presented to our hospital with a 6-week history of recurrent right-upper-quadrant pain with abdominal ultrasound findings compatible with hydatid cyst of the liver. The cyst was approached laparoscopically using the same hydatid asepsis as in open surgery. The cyst was evacuated laparoscopically and marsupialized, and its remaining cavity was packed with omentum. The patient did well postoperatively and was discharged home on the third postoperative day. He had minimal biliary leak that ceased spontaneously on the fifth postoperative day.

Laparoscopic treatment of hydatid cyst of the liver: initial experience with a small series of patients.

A laparoscopic technique to manage hydatid cyst of the liver is described. The technique is safe and simple and has the advantages of other abdominal laparoscopic operations. It also fulfills the prerequisite of open surgery of hydatid cyst of the liver, namely, the prevention of intraperitoneal spillage of cyst contents. Our technique enables treatment of the residual cyst cavity following aspiration of contents. In the past 15 months, 10 cysts (5-17 cm in diameter) in 6 patients were managed successfully using this approach, with no mortality or short-term recurrence.