Laparoscopic treatment of hepatic hydatid cysts

Background. Because of limited experience worldwide, controversies about th e laparoscopic treatment of liver hydatid cysts have not been resolved. The aim of this study was to describe the technical details of a laparoscopic method we developed in 1992 and report the initial results from an endemic area. Methods. Of the 30 consecutive patients with 33 liver hydatid cysts conside red for laparoscopic treatment during a 6-year period at a university hospi tal in Turkey, conversion to an open procedure was required in 7 patients ( 23%) while 23 patients with 25 cysts were able to be treated laparoscopical ly. Results. By using a special trocar to suspend the cyst against the abdomina l wall, laparoscopic simple drainage was performed in 16 patients (70%) and unroofing and drainage in 6 patients (26%). Pericystectomy was performed i n 1 patient (4%). Complications were observed in 1 patient (4%) perioperati vely and 4 patients (17%) postoperatively. Eleven patients (48%) were follo wed-up for a mean of 17 months (range, 3-72 months) and 1 recurrence (9%) w as detected. Conclusions. This report is a very large experience with the laparoscopic t reatment of liver hydatid cysts in the literature. We have established a te chnique yielding a comparable morbidity and recurrence rate to open series in early follow-up. We advocate that it is a safe and simple technique with potentially a decreased risk of intraabdominal spillage compared with the other laparoscopic methods described.