Management of hepatic hydatidosis by open versus laparoscopic surgery

Ashutosh Darbari, Abhinav Jauhari, Ambuj Shrivastava

Abstract


Background:Aim of current study was to compare between laparoscopic versus open management of the hydatid cyst of liver regarding complication rate, post-operative recovery course with different modality of treatment and hospital stay. This study shows our results of surgical treatment of liver hydatid cysts during a 2.5 years period.

Methods:A prospective study of 30 patients operated on in a 2.5 year period (April 2011 to October 2013) in department of general surgery of J.N. medical college, Sawangi (Meghe), Wardha, Maharashtra, with hepatic hydatid cyst. All patients were preoperatively treated with albendazole. 15 patients were tackled by laparoscopic technique (using Palanivelu hydatid system) and rest 15 underwent Open procedure as surgical approach.

Results:Patients operated by laparoscopic surgery shown a better post-operative recovery course, required less analgesia, mobilized and started on oral feed early, intra-abdominal drain was removed at a much earlier period as compared to open group patient, this not only reduced morbidity but also because of this patient could be discharged earlier.

Conclusion:Minimal invasive management, using Palanivelu hydatid system for aspiration and laparoscopic intervention, is an alternative to open surgery because of its ability to prevent spillage and thus minimize recurrences. It is better and safe to use laparoscopy in treatment of hydatid liver with less morbidity, mortality and recurrence rate in comparison with open technique.

 


Keywords


Laparoscopical treatment, Liver, Hydatid cyst, Palanivelu hydatid System, Abdominal approach

Full Text:

PDF

References


Romero-Torres R, Campbell JR. An interpretive review of the surgical treatment of hydatid disease. Surg Gynecol Obstet. 1965 Oct;121(4):851-64.

C. Palanivelu, Kalpesh Jani, Vijaykumar Malladi, R. Senthilkumar, P. S. Rajan, K. Sendhilkumar, et al. Laparosocpic management of hepatic hydatid disease. JSLS. 2006;10:56-62.

Amir Jahed AK, Fardin R, Farzad A, Bakshandeh K. Clinical echinococcosis. Ann Surg. 1975;182(5):541-6.

Huizinga WKJ, Grant CS, Daar AS. Hydatid disease. In: Morris PJ, Wood WC, eds. Oxford Textbook of Surgery. 2nd ed. New York, NY: Oxford University Press; 2000: 3298-3305.

King CH. Cestodes (tapeworms). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 4th ed. New York, NY: Churchill Livingstone; 1995: 2544-2553.

Gomez R, Marcello M, Moreno E, Hernández D, Calle A, Palomo J, et al. Incidence and surgical treatment of extra-hepatic abdominal hydatidosis. Rev Esp Enferm Dig. 1992;82:100-3.

Amr SS, Amr ZS, Jitawi S, Annab H. Hydatidosis in Jordan: an epidemiological study of 306 cases. Ann Trop Med Parasitol. 1994;88:623-7.

Kammerer WS, Schantz PM. Echinococcal disease. Infect Dis Clin North Am. 1993;7:605-18.

Magistrelli P, Masetti R, Coppola R, Messia A, Nuzzo G, Picciocchi A. Surgical treatment of hydatid disease of the liver: a 20-year experience. Arch Surg. 1991;126:518-22.

Akhan O, Ozmen MN, Dincer A, Sayek I, Gocmen A. Liver hydatid disease: long-term results of percutaneous treatment. Radiology. 1996;198:259-64.

Deger E, Hokelek M, Deger BA, Tutar E, Asil M, Pakdemirli E. A new therapeutic approach for the treatment of cystic echinococcosis: percutaneous albendazole sulphoxide injection without respiration. Am J Gastro-enterol. 2000;95:248-54.

Vutova K, Mechkov G, Vachkov P, Petkov R, Georgiev P, Handjiev S. Effect of mebendazole on human cystic echinococcosis : the role of dosage and treatment duration. Ann Trop Med Parasitol. 1999;93:357-65.

Agaoglu N, Turkyilmaz S, Arslan MK. Surgical treatment of hydatid cysts of the liver. Br J Surg. 2003;90:1536-41.

Chowbey PK, Shah S, Khullar R, Sharma A, Soni V, Baijal M, et al. Minimal access surgery for hydatid cyst disease: laparoscopic, thoracoscopic and retroperitoneoscopic approach. J Laparoendosc Adv Surg Tech. 2003;13:159-65.

Manterola C, Fernandez O, Munoz S, Vial M, Losada H, Carrasco R, et al. Laparoscopic pericystectomy for liver hydatid cyst. Surg Endosc. 2002;16:521-4.

Barnes SA, Lillemoe KD. Liver abscess and hydatid cyst disease. In: Zinner MJ, Schwartz SI, Ellis H, eds. Maingot’s Abdominal Operations. 10th ed. Stamford, CT: Appleton & Lange; 1997: 1534-1545.

Cohen H, Paolillo E, Bonifacino R, Botta B, Parada L, Cabrera P, et al. Human cystic echinococcosis in a Uruguayan community: a sonographic, serologic, and epidemiologic study. Am J Trop Med Hyg. 1998;59(4):620-7.

Niscigorska J, Sluzar T, Marczewska M, Karpińska E, Boroń-Kaczmarska A, Morańska I, et al. Parasitic cysts of the liver: practical approach to diagnosis and differentiation. Med Sci Monit. 2001;7(4):737-41.

Chautems R, Buhler L, Gold B, Chilcott M, Morel P, Mentha G. Long term results after complete or incomplete surgical resection of liver hydatid disease. Swiss Med Wkly. 2003;133:258-62.

Pedrosa I, Saiz A, Arrazola J, Ferreirós J, Pedrosa CS. et al. Hydatid disease: radiologic and pathologic features and complications. Radiographics. 2000;20(3):795-817.

Bickel A, Loberant N, Shtamler B. Laparoscopic treatment of hydatid cyst of the liver: initial experience with a small series of patients. J Laparoendosc Surg. 1994;4(2):127-33.

Khoury G, Jabbour-Khoury S, Soueidi A, Nabbout G, Baraka A. Anaphylactic shock complicating laparoscopic treatment of hydatid cysts of the liver. Surg Endosc. 1998;12(5):452-4.

Yaghan R, Heis H, Bani-Hani K, Matalka I, Shatanawi N, Gharaibeh K, et al. Is fear of anaphylactic shock discouraging surgeons from more widely adopting percutaneous and laparoscopic techniques in the treatment of liver hydatid cyst? Am J Surg. 2004;187(4):533-7.

Bickel A, Eitan A. The use of a large transparent cannula, with a beveled tip, for safe laparoscopic management of hydatid cysts of liver. Surg Endosc. 1995;9:1304-5.

Sayek I, Cakmakei M. Laparoscopic management of echinococcal cysts of the liver. Zentralbl Chir. 1999;124(12):1143-6.