Laparoscopic versus Open Management of Hydatid Cyst of Liver

Background: To compare laparoscopic versus open management of the hydatid cyst of liver regarding recurrence rate, the surgical approach to liver echinococcosis is still a controversial issue. This study shows our results of surgical treatment of liver hydatid cysts during a 5 years period. Methods: A prospective study of 32 patients operated on in a 5-year period (1999-2003) in Dubrava University Hospital, Zagreb, Croatia, with hepatic hydatid cyst. All patients were preoperatively treated with albendazole. In 32 patients, total pericystectomy without opening the cyst cavity was performed laparoscopically, other procedures were used as surgical approach. Results: There was no mortality after 5 to 6 months follow-up, but in one patient, in the open partial pericystectomy group, recurrence of the disease occurred after 2 to 3 years. When a laparoscopic procedure was done, there were no complications or recurrence. The median operative duration for open surgery was 100.0 minutes (range 60.0-210.0) and for laparoscopic surgery 67.5 minutes (range 60.0-120.0). The median length of hospitalization for open surgery was 8.0 days (range 7.0-14.0) and for laparoscopic surgery 5.0 days (range 4.0-7.0). Conclusion: Total pericystectomy without opening the cyst cavity, preceded by preoperative albendazole therapy is the method of choice for hepatic hydatid cyst treatment. Despite the small group of patients, our first results show laparoscopic total pericystectomy, without opening the cyst cavity, in the treatment of hepatic hydatid cyst.