Results of Minimally Invasive Methods in the Treatment of Liver Hydatid Cyst

Objective: The most common cause of hydatid cyst disease is Echinococcus granulosus. Nowadays, minimally invasive methods such as laparoscopy used in the treatment of hepatic hydatid cyst (HHC). In this study, it is aimed to share the clinical, surgical and postoperative data of patients who underwent laparoscopic surgery with a diagnosis of HHC in our clinic. Methods: Data of 105 patients who underwent laparoscopic surgery for HHC between January 2011 and January 2020 were retrospectively analyzed. Patients who were diagnosed with HHC by clinical, indirect hemagglutination test, upper abdominal ultrasonography (USG) and upper abdominal tomography were included in the study. All patients received 10 mg / kg / day albendazole therapy for a total of six weeks, two weeks preoperatively and four weeks postoperatively. Demographic information, clinical characteristics, and the incidence and percentage of complications were analyzed by simple manual calculation. Results: 64 (60.95%) of 105 patients who underwent laparoscopic surgery were male and 41 (39.05%) were female. The mean age was 40.6 ± 11.7 years (18-65 age range). The mean cyst diameter was 8.4 cm in size (minimum: 6 cm, maximum: 16 cm). The mean operation time was 55 ± 11.45 minutes (Range: 42 to 70 minute). The mean hospitalization period of the patients was 3.7 days (Range 2 to 7). No recurrence was observed in the 18-month follow-up of the patients. Conclusıons: HHC is a common disease in our country, and we think that laparoscopic approach is an effective surgical treatment option in suitable patients and in experienced centers.

Keywords:

hydatid cyst, liver laparoscopy, minimally invasive,

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1. Wen H, Vuitton L, Tuxun T, et. al. Echinococcosis: Advances in the 21st Century. Clin Microbiol Rev. 2019; 32.
2. Çaycı M, Tihan D. Karaciğer Kist Hidatik Tedavisinde Güncel Yaklaşım. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2016;42: 53-9.
3. Shrestha S.K, Thapa P.B, Maharjan D.K, Tamang T.Y. Laparoscopic Approach for Management of Hydatid Cyst of Liver. J Nepal Health Res Counc 2017; 15: 67- 70.
4. Mirabile E, Solomon N, Fields PJ, Macpherson CNL. Progress towards international adoption of the World Health Organization ultrasound classification of cystic echinococcosis. Acta Trop. 2019; 189: 6-9.
5. Vardakostas D, Damaskos C, Garmpıs N, et.al. Minimally invasive management of hepatic cysts: indications and complications. European Review for Medical and Pharmacological Sciences. 2018; 22: 1387-96.
6. Mueller P.R, Dawson S.L, Ferrucci J.T, Nardi G.L. Hepatic echinococcal cyst: successful percutaneous drainage. Radiology. 1985; 155: 627-8.
7. Vuitton D, Meslin F, Mac Pherson C, Brunetti E, Filice C.World Health Organization Informal Working Group on echinococcosis. PAIR: an option for the treatment of cystic echinococcosis.2002; Bull World Heal Organ.
8. Akhan O, Erdoğan E, Ciftci TT, et al. Comparison of the Long-Term Results of Puncture, Aspiration, Injection and Re-aspiration (PAIR) and Catheterization Techniques for the Percutaneous Treatment of CE1 and CE3a Liver Hydatid Cysts: A Prospective Randomized Trial. Cardiovasc Intervent Radiol. 2020; 43: 1034-40.
9. Katkhouda N, Fabiani P, Benizri E, Mouiel J. Laser resection of a liver hydatid cyst under videolaparoscopy. Br J Surg 1992; 79: 560-1.
10. Kayaalp C. Hydatid cyst of the liver. Surg Liver, Biliary Tract, Pancreas 2007; 4: 952-70.
11. Busić Z, Lemac D, Stipancić I, et al. Surgical treatment of liver echinococcosis--the role of laparoscopy. Acta Chir Belg 2006; 106: 688-91.
12. Avgerinos E.D, Pavlakis E, Stathoulopoulos A, et al. Clinical presentations and surgical management of liver hydatidosis: our 20 year experience. HPB (Oxford) 2006; 8: 189-93.
13. Tuxun T, Zhang JH, Zhao JM, et al. World review of laparoscopic treatment of liver cystic echinococcosis – 914 patients. Int J Infect Dis. 2014; 24: 43-50.
14. Aktan AO, Yalin R. Preoperative albendazole treatment for liver hydatid disease decreases the viability of the cyst. Eur J Gastroenterol Hepatol. 1996; 8: 877-9.
15. Sokouti M, Sadeghi R, Saeid Pashazadeh S, et.al. A systematic review and meta-analysis on the treatment of liver hydatid cyst: Comparing laparoscopic and open surgeries. Arab Journal of Gastroenterology Volume 18, 3: 2017, p: 127-35
16. Zaharie F, Bartos D, Mocan L, et.al. Open or laparoscopic treatment for hydatid disease of the liver? A 10-year single-institution experience. Surgical Endoscopy 2013; 27: 2110–6.
17. Tuxun T , A ji T , T ai Q, et.al. Conventional Versus Laparoscopic Surgery for Hepatic Hydatidosis: a 6- Year Single-Center Experience. Journal of Gastrointestinal Surgery 2014; 18: 2 p: 1155–60.
18. Pandey A, Chandra A, Masood S. Abdominal echinococcosis: outcomes of conservative surgery. Transactions of The Royal Society of Tropical Medicine and Hygiene, 2014; 108(5) p:264–68.
19. Busic Z , C upurdija K , S ervis D , et.al. Surgical Treatment of Liver Echinococcosis Open or Laparoscopic Surgery? Coll Antropol 2012: 36: 1363-6.
20. Bedioui H, Bouslama K, Maghrebi H, et.al. Predictive factors of morbidity after surgical treatment of hepatic hydatid cyst. Pan Afr Med J. 2012; 13: 29.
21. Manterola C, Otzen T, Muñoz G, et.al. Surgery for hepatic hidatidosis. Risk factors and variables associated with postoperative morbidity. Overview of the existing evidence. Cir Esp. 2017; 95: 566-76.
22. Goumas K, Poulou A, Dandakis D, et.al. Role of endoscopic intervention in biliary complications of hepatic hydatid cyst disease. Scand J Gastroenterol. 2007; 42: 1113-9.
23. Sharma B.C, Reddy R.S, Garg V. Endoscopic management of hepatic hydatid cyst with biliary communication. Dig Endosc. 2012; 24: 267-70.
24. Sayır F, Çobanoğlu U. Yöremizin Endemik Paraziter Hastalığı: Kist Hidatik. Van Tıp Dergisi:2013; 20: 288- 93.