Publications of Faculty of Medicine:Laparoscopic Pcricystectomy for Hepatic Hydatid Cysts: Prospective Evaluation of Feasibility and Outcome: Abstract

Laparoscopic Pcricystectomy for Hepatic Hydatid Cysts: Prospective Evaluation of Feasibility and Outcome
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Abstract Patients & Methods: The study included 17 patients; 6 males and 11 females had CT confirmed diagnosis of hydatid cyst Preoperative laboratory and radiological evaluation was conducted and cysts of Gharbi types II and III were included in the • study. Medical therapy was used for 4 weeks before and 12 weeks after surgery. All • •patients had laparoscopie Pericystectomy with omentoplast and drainage of the residual cyst with a negative suction catheter. Results: Right upper quadrant pain was the main presenting symptom in 12 patients, 3 patients were detected incidentally during routine abdominal ultrasonography for unrelated causes, and 2 patients were unresponsive to treatment and showed recent enlargement of size. Total number of cysts was 24 cysts; 3 cysts were of Gharbi type II and 21 cysts were type HI. Mean cystic diameter was 7+2.2 cm. Seven cysts were in tne superior most region of the liver (segment VII and VIII), and 17 cysts were in • the easily accessible anteroinferior aspect of the liver (segments II to VI). Aspirated cystic fluid of 5 cysts was bacterially infected. Mean operating time was 79.2+23.8 minutes. No open-conversion was required with only 2 patients had minimal intraoperative spillage. Omentoplasty was performed in 12 patients but was not feasible in the other 5 patients who required peritoneal drainage. Early postoperative complicationi included low-grade fever not accompanied by leucocytosis in 6 patients and persistent drainage exceeding 4 days in 3 cases. Mean hospital stay was 6.4+1.2 days and with a mean duration of 12.4+4.3 months. Recurrence of a cystic lesion on serial imaging was noted within 6 months in 3 patients (17.6%). ' Conclusion: Laparoscopic pericystectomy for properly selected hepatic hydatid cyst ries cau rsraefnec ae nrdat ee.f fective procedure with minimal postoperative morbidities and low