Laparoscopic surgery in hepatic hydatid cysts: A technical improvement

Hepatic hydatid cysts are a common surgical problem that is encountered in many tropical countries, including India. Open surgical exploration and exc ision had been the mainstay of treatment until the advent of laparoscopy. I n 1998, we successfully managed six cases of large hepatic hydatid cysts us ing the videoendoscope, with excellent postoperative follow-up results. Fou r men and two women participated in this study, with patient ages ranging f rom 28 to 42 years. The duration of the disease ranged from 1.3 to 2.8 year s. All patients had undergone preoperative albendazole therapy for more tha n 2 months. Complete evacuation of the cyst contents, including all daughte r cysts and laminated membrane, along with a subtotal excision of the extra hepatic part of the cyst wall, was accomplished without any spillage into t he peritoneal cavity. The saucerized cavity was drained. The drains were re moved 6 to 9.4 days after a check ultrasound. Postoperative follow-up range d from 3 to 9 months and revealed no evidence of a recurrence in the abdome n. It is possible with carefully planned placement of trocars to completely eliminate the risk of spillage, and therefore not compromise the standard principles of hydatid surgery.