Laparoscopic Treatment Of Hepatic Hydatid Cyst

Ekhlayef Mughir Al- Doghan, Ibrahim; Khalid Hussein, Haitham; Abdulameer Jasim, Hasanain

	Laparoscopic Treatment Of Hepatic Hydatid Cyst
Mustansiriya Medical Journal
Article 1, Volume 16, Issue 2, 2017, Pages 8-12
Authors
Ibrahim Ekhlayef Mughir Al- Doghan; Haitham Khalid Hussein; Hasanain Abdulameer Jasim
Abstract
Background: Hydatid Cyst disease is caused by Echinococcus Granulosis which is a parasite that inhabits the intestine of dogs and canines as definitive hosts. Humans are infected accidentally after ingestion of the parasitic eggs. The commonly affected areas are the liver, lung, brain and other viscera. A variety of treatment modalities were employed starting from medical therapy for small cysts, to the classical surgical procedures. Nowadays Hepatic Hydatid Cyst can be effectively managed by laparoscopic surgery. Aim: For evaluate the feasibility and safety of laparoscopy in the management, of Hepatic Hydatid Cysts regarding complications, recurrence rate, duration of surgery and hospital stay. Patients and Methods: A study of 54 patients with hydatid cysts of liver, who underwent laparoscopic surgery at Al-Yarmouk teaching hospital, and two private hospitals in Baghdad. Results: From Oct. 2009 - Oct. 2016 a study of 54 patients of hepatic hydatid cysts, who underwent laparoscopic procedure at Al-Yarmouk teaching hospital, and two private hospitals in Baghdad – Iraq. All patients were treated preoperatively with albendazole. A successful laparoscopic surgery was performed for 47 patients (87.03%), by de-roofing of the cyst wall and evacuation of the germinal membrane, daughter cysts and hydatid fluid by a 10mm sucker after packing of the peritoneal cavity with 20 per cent hypertonic saline-soaked packs and instilling 20 per cent hypertonic saline into the cyst cavity as a Scolicidal agent before it is opened. The cavity was then irrigated with normal saline and a drain placed inside it, while conversion to an open surgical procedure was done to 7 patients (12.96%).Due to various reasons, as deep intraparenchymal cysts 1 (1.85%) patient, posteriorly located cyst 3 (5.55%) patients, more than three cysts (multiple cysts) 1 (1.85%) patient, cysts with thick and calcified walls 1 (1.85%) patient, and cysts characterized by a heterogeneous complex mass 1 (1.85%) patient. Postoperative complications occurred in7 (13%) patients. About 46(85.2%) of patients were discharged from hospital within 3 days, and about 8(14.8%) of patients discharged from hospital within 4-7days., one patient, who converted to open surgery recurrence of the disease occurred after 3 years, exploration was done without complications. No mortality in this study. Conclusion: Treatment of Hepatic Hydatid cyst by Laparoscopy is effective, feasible, safe, early recovery with low morbidity and no mortality.
Keywords
Hepatic Hydatid cyst; Laparoscopy; complications

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