Page 34 - WJOLS - Surgery Journal

World Journal of Laparoscopic Surgery, January-April 2009;2(1):35-39
Laparoscopic Treatment of Hepatic Hydatid Disease
Laparoscopic Treatment of Hepatic

Hydatid Disease

Alaa Bakir Raheem
Department of General Surgery, Hilla Teaching General Hospital, Babylon, Iraq

Abstract 2008) and universally widely accepted and recognized was selected.
The rapid development of laparoscopic techniques revolutionized the The selected papers were screened for further references. criteria for
optimum surgical intervention in Echinococcus granulosus disease. selection of literatures were the number of cases (more than 50 cases).
The procedure was shown to be feasible and safe, offering the Methods of analyses whether statistical or nonoperative procedures
advantages of laparoscopic surgery. Sience the first report on the long- only universally accepted chosen and the institution where the study
term follow-up of this operation in a large group of patients. 1
was done in specialized institutions for laparoscopic surgery.
Background: Echinococcal disease is still a serious health problem in During this study we observed that patient response to surgical
certain parts of the world. trauma, hospital hostility, rapid turn over of hospital beds, cost
In the human being the liver is the most frequent organ affected.
The natural history of liver hydatidosis in humans till now is poorly effectiveness, less morbidity, no mortality, early resuming normal
understood and Different morphological appearances was observed. 2 usual activity, minimal postoperative complication, reduced operative
Over recent decades, various reports have been published time, early recovery from general anesthesia, decreasing risk of surgery,
comparing standard surgical and more conservative modalities for the access to certain locations difficult to be approached in open surgery
treatment of the disease. Although Hand-assisted laparoscopic surgery all these parameters are better in minimally access surgery than in

(HALS) has been proposed as a useful alternative to conventional open conventional surgery.

open orlaparoscopic surgery and seems tobe a promising technique in
laparoscopic treatment of hydatid cyst which has been applied with INTRODUCTION

success as well as with a wide range of digestive tract–related surgical
3
procedures. Gasless laparoscopy also had been introduced in the Hydatid cyst is zoonotic disease with a worldwide distribution
treatment of liver hydrated and has the advantage of permitting the use and is endemic in many cattle-raising regions of the

of conventional instruments during minimally invasive procedures Mediterranean,middle and far east, South America, Australia,
5

with a promising results. With many advantages regarding technique. 4 and in certain areas in North America. Most cases are caused

Keywords: Laparoscopic management of liver hydatid cysts, by the cestode tapeworm Echinococcus granulosus that is

6,7
Echinococcus granulosus. found in the small bowel of carnivores. In this disease the

human is intermediatehost. The parasite exists only inits larval
Aims and objectives: Many review articles was written all over the
worlds regarding precautions, accessibility, operative risks, remote form, other species Echinococcus multilocularis is rare
satisfaction in operative results and duration of free disease following occurrence and not include in the study .
prolonged regular follow-up. Complications include cyst rupture with intraperitoneal

The aims of this study was to compare the effectiveness and dissemination of disease, anaphylactic reaction, pressure on

safety of laparoscopic intervention and conventional open surgery contiguous organs, secondary infection, and intrabiliary tree
6,8
that practiced decades of years ago and regarded as standard modality rupture of cyst causing obstructive jaundice. The old standard
treatment of hepatic Echinococcus granulosus disease. The following approach in the treatment of liver cysts is open surgery; the
parameters were evaluated for both laparoscopic and open procedures principles and various techniques have been extensively

modalities. reviewed, 6,9,10 whoever laparoscopicsurgical techniques to treat

Methods of patients selection, operative technique, operating hydatid cysts of the liver have been gradually introduced. 11,12

time, intraoperative and postoperative complications, postoperative
pain and amount of pain killers. Time until resumption of diet, post- Although reported to be successful,the series are still in going,

operative morbidity, hospital stay, cost effectiveness, and quality no one of the both methods has been reported to be out of risk
of life analyses. from above mentioned complications.
In the last decade laparoscopic treatment of hepatic hydatid
Material and methods: A literature search was performed using Medline
and the search engine Google, Springer link and Highwire press. The disease has been increasingly popular and has undergone a

following search terms used: laparoscopic management of liver hydatid revolutionparallel to the progress in laparoscopic surgery. There

cysts Echinococcus granulosus. There were over thousand of literatures areencouraging preliminary results; however, there have been

and papers published discussing this subject. Most recent (2000- limitedreports concerning long-term results of this technique. 13
35