Laparoscopic management of hydatid cysts of the liver at a tertiary care hospital

Objective: to evaluate the feasibility and safety of laparoscopy in the management of hydatid cysts. methodology: all consecutive patients diagnosed with liver hydatid disease were offered laparoscopic management. we performed select conservative procedures using standard laparoscopic instruments after sterilization of the cysts with 20% hypertonic saline. deroofing, evacuation and partial cystectomy were performed. omentoplasty was performed, and a drain was placed in the cyst cavity. results: a total of 63 patients (m:f=48:15) with 75 cysts were managed successfully by laparoscopy. the mean age ± sd of the patients was 38.59 ± 11.46 years old. the mean operative time ± sd was 88.24 ± 23.52 minutes (range: 52-145 minutes). the mean size of the cysts was 9.2 cm (range: 5.8-16.5cm). the mean hospital stay ± sd was 3.49 ± 1.16 days (range: 1-7 days). there was no disease or procedure related mortality. recurrence of a cyst was observed in 3 (4.76%) cases. open surgery had to be performed on four patients. there were no major complications; minor biliary leaks were observed in 7 cases and cavity infections in 5 cases. the mean follow-up ± sd in 51 patients was recorded as 28.9 ± 31 months. conclusion: laparoscopic treatment of hydatid cysts of the liver is safe and effective, with low morbidity and a low recurrence rate in uncomplicated cysts. despite some of its limitations, the procedure is a good alternative to open surgery in select cases.