Surgical alternatives for hepatic hydatid disease.

BACKGROUND/AIMS: In this study we report on our method in the treatment of hepatic hydatid disease (HHD) and analyze the outcomes after minimal invasive surgery (MIS) and open surgery (OS). We evaluated the performance of MIS in patients with solitary HHD.

METHODOLOGY: In total 136 patients with HHD were operated on in our department, 69 of them underwent OS and the other 67 patients were treated with MIS. MIS is a combination of minimal incision laparotomy with laparoscopical video assistance. An specially developed device for cyst evacuation was used during MIS. All patients were followed-up for 6 months postoperatively.

RESULTS: The average duration of MIS surgery was of 67.5 ± 5min and for OS it was 98.6 ± 12.2min. The length of incision was 6.2 ± 1.1cm in MIS and 21.5 ± 2.5cm in OS. Hospital stay was 5.8 ± 1.4 days and recovery period 13.4 ± 2.1 days for patients after MIS, and 12.5 ± 2.1 days and 25.2 ± 2.6 days for patients after OS, respectively. Postoperative complications were observed more frequently in the OS group.

CONCLUSIONS: In suitable cases of HHD, MIS seems to be a good alternative to traditional OS for it is comparably safe and with a better postoperative outcome and a shorter postoperative rehabilitation period. Based on this experience we can advice MIS in selected patients with definitive indications.