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Radical Laparoscopic Treatment for Liver Hydatidosis

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Abstract

Background

There is no scientific evidence to show which surgical technique should be used in treating hydatidosis of the liver; nor is there consensus on whether laparoscopy should be used in hydatidosis, because of the risk of dissemination or anaphylaxis.

Materials

We conducted a multicenter study of laparoscopic radical surgery for hydatidosis of the liver (LRSH). The main objectives of the study were to determine the feasibility of LRSH, to examine the associated morbidity, and to evaluate the associated recurrence rate.

Materials and methods

The present report is based on a retrospective multicenter study of patients with hydatid disease of the liver treated by LRSH. The study period was from January 2000 to April 2012.

Results

There were 37 patients (46 % male) with 43 cysts. The median age was 53.1 years. Median cyst size was 5.8 cm. The most common location of the cyst was the left lateral sector (62 %). The median number of trocars used was 4. Protective scolicide-soaked swabs were used in 57 % of patients. We performed 24 total closed cystectomies, 12 left lateral sectionectomies, and 4 liver resections. The median operating time was 185 min and the mean blood loss was 184 mL. The conversion rate was 8 %. Morbidity was 16 % and mortality 0 %. The length of hospital stay was 4.8 days. No cyst recurrence was observed after a follow-up of 30.6 months.

Conclusions

Despite the limitations and biases of a retrospective multicenter study, we believe that LRSH is feasible in favorable segments but is technically demanding. The low morbidity and absence of recurrence suggest that LRSH should be performed whenever feasible.

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Acknowledgments

The authors are grateful to the following authors who have contributed cases to this study: Andres Valdivieso, Hepato-Pancreato-Biliary Surgical Unit. Department of Surgery. Hospital de Cruces. Bilbao (Spain); Juan L. Blas, Department of Surgery. Hospital Royo Vilanova. Zaragoza (Spain); David Fernandez-Luengas, HPB Unit, Hospital Infanta Cristina, San Sebastian de los Reyes (Madrid), Spain; S. Lopez Ben and J. Figueras, HPB Unit. Department of Surgery. Hospital Josep Trueta. Girona (Spain); Ricardo Robles, HPB Unit, Department of Surgery. Hospital Virgen de la Arrixaca. Murcia (Spain). Fernando Rotellar Department of Surgery. Clinica Universitaria de Navarra. Pamplona (Spain).

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Authors and Affiliations

  1. Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery, Guadalajara University Hospital, Guadalajara, Spain

    Jose M. Ramia

  2. Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain

    Ignasi Poves

  3. Department of Surgery, Hospital Infanta Elena, Madrid, Spain

    Camilo Castellón

  4. Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery, Hospital Clínico Universitario, Madrid, Spain

    Luis Diez-Valladares

  5. Department of Surgery, Hospital 12 de Octubre, Madrid, Spain

    Carmelo Loinaz

  6. Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery, Hospital Miguel Servet, Saragossa, Spain

    Alejandro Serrablo

  7. Hepato-Pancreato-Biliary Surgical Unit, Department of Surgery, Hospital Carlos Haya, Malaga, Spain

    Miguel A. Suarez

Authors
  1. Jose M. Ramia
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  2. Ignasi Poves
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  3. Camilo Castellón
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  4. Luis Diez-Valladares
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  5. Carmelo Loinaz
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  6. Alejandro Serrablo
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  7. Miguel A. Suarez
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Corresponding author

Correspondence to Jose M. Ramia.

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Ramia, J.M., Poves, I., Castellón, C. et al. Radical Laparoscopic Treatment for Liver Hydatidosis. World J Surg 37, 2387–2392 (2013). https://doi.org/10.1007/s00268-013-2150-2

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  • DOI: https://doi.org/10.1007/s00268-013-2150-2

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