Even though echinococcal cysts have been cured by puncture and instillation
of scolicidal medications, surgery is still the mainstay of the treatment
of hydatid disease. The aim of the surgical treatment is the elimination of
scolices, the removal of all viable parts of the cyst and the obliteration
of the remaining cavity. This can be achieved by resective procedures, but
also by a more conservative approach with drainage and obliteration of the
cyst. The latter procedure can be done by open surgery or laparoscopically
. The disadvantages of the laparoscopic approach are the increased danger o
f contamination of the abdominal cavity with scolices and difficulties to a
spirate a highly viscous cyst content. Furthermore, cysts which are located
deep in the parenchyma of the liver should not be approached laparoscopica
lly because of the significant danger of hemorrhage. The advantage of the l
aparoscopic approach in selected cysts, i. e. those which are located super
ficially and having a liquid content, are a shorter hospital stay, lower in
cidence of wound infection and the ability of the surgeon to inspect the in
side of the cyst more thoroughly and rule out daughter cysts and connection
s to the biliary tract. A review of the literature (Iz 76) indicates that i
n most laparoscopically treated hydatid cysts of the liver a simple drinage
(59 %) or an unroofing (31 %) is performed. The complication rate is 21 %.
Because there are no longterm observations after laparoscopic operations f
or hydatid disease the question of recurrence cannot yet be answered.