Minimally Invasive Treatment of Hepatic Hydatid Cysts
Background. Hydatid cyst is a parasitosis caused by Taenia Echinococcus. In the last 10 years, new methods of treatment of the hydatid cyst have been proposed (percuta-neous or laparoscopic).
Method. This retrospective study includes 24 patients with hepatic hydatid cyst (HHC) who were treated by a minimally invasive approach, 18 women and 6 men (average age 49.3 years), representing 10% of all patients with HHC.
Results. The average operative time was shorte-ned to about 70 minutes. The conversion rate was 25%. In all cases managed laparoscopically, the prophylactic flooding of the peritoneal cavity was realized with peroxide solution 10‰ or with hypertonic saline 30%. The inactivation of the cyst was performed with hypertonic saline in most of the cases. Most cysts were univesicular (62.5%), but there were also multivesicular cysts (37.5%). In two cases patients presented hepatic and pulmonary hydatid disease which were also approached in a minimally invasive manner. The average postoperative period of the cases treated laparoscopically was 6 days and for the converted cases it was 13.3 days.
Conclusion. The open surgical approach of HHC is highly expensive due to the postoperative period, therefore a laparoscopic approach may be advocated. The minimally invasive method shortens the postoperative hospitalization period, reduces the number of complications as well as the overall costs and facilitates a rapid social reintegration. All these arguments recommend the laparoscopic approach as a standard procedure for hepatic hydatid disease.