Evaluation and comparison of the early outcomes of open and laparoscopic surgery of liver hydatid cyst

Abstract

Background and aim: Surgery is the mainstay for treatment of liver hydatid cyst. Different<br><br>surgical procedures have been suggested but it is important to select the most appropriate<br><br>treatment to obtain the best results with the lowest rate of recurrence and minimal morbidity<br><br>and mortality. The aim of this study was to evaluate the early outcomes of open and<br><br>laparoscopic surgery of hydatidosis.<br><br>Materials and methods: In this study, 75 patients with uncomplicated liver hydatid cyst<br><br>were prospectively assigned to either groups of laparoscopic surgery (37, 50.68%) or open<br><br>procedure (36, 49.32%) during period of 2007–2012. Conversion to open surgery was<br><br>required in two patients (2.67%) which excluded from the study. Patients were followed for<br><br>about 17.86±17.64 months.<br><br>Results: Participants included 73 patients of 49 (67.12%) female and 24 (32.88%) male with<br><br>the mean age of 38.97±16.48 years. There was no statistically significant difference between<br><br>two groups with regard to sex, occupation and mean diameter of the cysts. Bilious staining of<br><br>the cyst content was seen in 23 (35.94%) patients during surgery and maximum diameter of<br><br>91 mm was considered as a cut point for predicting postoperative fistula with 69.2%<br><br>sensitivity and 41.1% specificity. The mean duration of operation, postoperative pain,<br><br>hospitalization time and time to return to work were significantly lower in laparoscopic<br><br>group. Postoperative biliary fistula, cyst cavity infection and wound infection were not<br><br>different between the two groups.<br><br>Conclusion: Laparoscopic surgery seems to be effective and safe with low morbidity rates<br><br>for uncomplicated cysts in accessible segments of the liver.<br><br>Keywords: Echinococcosis, Hepatic; Laparoscopy; Open Surgery; Treatment Outcome