Mehmet Akif Türkoğlu, Umut İhsan Emreol, Naciye Bozkurt, , Onur Metindoğan

Karaciğer Hidatik Kist Olgusunda Laparoskopik Perikistektomi

Cerrahi teknoloji ve ekipmanlardaki hızlı gelişmelere rağmen karaciğer hidatozu (LH) tedavisinde laparoskopi yaygın olarak uygulanmamaktadır. Burada preoperatif görüntülemeye dayanarak laparoskopik radikal cerrahi ile tedavi edilen bir LH olgusunu sunuyoruz. 24 yaşında kadın hasta karaciğer kist hidatik nedeniyle hastanemize sevk edildi. Preoperatif bilgisayarlı tomografide 75 mm büyüklüğünde, karaciğer segment 5 - 6’da tutulum gösteren ve safra kesesine adheze laminer membranlı hidatik kist görüldü. Hastaya, ponksiyon-aspirasyon-enjeksiyon-reaspirasyon işleminin başarısız olması üzerine laparoskopik perisistektomi ve kolesistektomi uygulandı. Hasta postoperatif 1. günde sorunsuz taburcu edildi. Seçilmiş olgularda parazitlerin tamamen yok edilmesi için tek tedavi seçeneği total perisistektomidir. Özellikle periferik yerleşimli, majör duktal yapılar ve damarlarla ilişkisi olmayan, 10 cm’den küçük karaciğer kist hidatik olgularında laparoskopik yaklaşım güvenle uygulanabilir.

Laparoscopic Pericystectomy in A Case of Liver Hydatid Cyst

Despite the rapid developments in surgical technology and equipment, laparoscopy has not been widely practiced in the treatment of liver hydatosis (LH). Here, we report a case of LH treated with laparoscopic radical surgery with appropriate selection based on preoperative imaging. A 24-year-old woman was referred to our hospital due to hepatic hydatid cyst. Preoperative computed tomography showed hydatid cyst with detached laminar membranes, 75 mm in size, involving segment 5 - 6 of the liver and attached to gallbladder. She underwent laparoscopic pericystectomy combined with cholecystectomy after a failed puncture-aspiration-injection-reaspiration. The patient was discharged uneventfully on postoperative day one. Total pericystectomy is the only treatment option for complete eradication of the parasites in selected cases. Especially, laparoscopic approach can be safely performed in cases with hepatic hydatid cyst smaller than 10 cm, located peripherally and irrelevant to major ductal structures and vessels.

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