ANZ journal of surgery · 2012
Laparoscopic treatment of hepatic hydatid disease.
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Koea Jonathan B
Аннотация
BACKGROUND: Hepatic hydatid disease is now rare in Australasia. However, it remains a significant problem in endemic areas. Many cases are now managed using minimally invasive techniques and this paper reviews the current status of laparoscopic approaches to hepatic hydatid disease.
METHODS: A Medline data search was performed using the search terms of Ecchinococcos, laparoscopy, hepatectomy and pericystectomy. All publications from all publication years, including foreign language publications, were included.
RESULTS: Eight series have been published comprising five or more patients, with most utilizing techniques of laparoscopic cystectomy. All series managed Gharbi cyst types I-IV, and median operative times were between 60 and 82 min. Seven conversions were reported (3%) for problems with access or bleeding. There was one reported fatality, and between 5% and 45% (median 13%) of patients developed complications. Three cases of anaphylaxis were reported and 14 cases of bile fistula were reported (median incidence: 6%). Hospital stays were between 3 and 10 days (median stay: 3.5 days). Two series report recurrences (recurrence rates of 3% and 4%) and these were in patients not treated with preoperative albendazole.
CONCLUSION: Laparoscopic surgical techniques have been successfully applied to the treatment of hepatic hydatid cysts. While the uptake of these procedures is limited to areas of high prevalence and units with a specific interest, laparoscopic surgery is now one of the management options available to treat hepatic hydatid disease.
METHODS: A Medline data search was performed using the search terms of Ecchinococcos, laparoscopy, hepatectomy and pericystectomy. All publications from all publication years, including foreign language publications, were included.
RESULTS: Eight series have been published comprising five or more patients, with most utilizing techniques of laparoscopic cystectomy. All series managed Gharbi cyst types I-IV, and median operative times were between 60 and 82 min. Seven conversions were reported (3%) for problems with access or bleeding. There was one reported fatality, and between 5% and 45% (median 13%) of patients developed complications. Three cases of anaphylaxis were reported and 14 cases of bile fistula were reported (median incidence: 6%). Hospital stays were between 3 and 10 days (median stay: 3.5 days). Two series report recurrences (recurrence rates of 3% and 4%) and these were in patients not treated with preoperative albendazole.
CONCLUSION: Laparoscopic surgical techniques have been successfully applied to the treatment of hepatic hydatid cysts. While the uptake of these procedures is limited to areas of high prevalence and units with a specific interest, laparoscopic surgery is now one of the management options available to treat hepatic hydatid disease.