Efficacy and Safety of Laparoscopic Management Techniques in Hepatic Hydatid Disease

Open Access

Abstract

Introduction: Hepatic hydatid disease remains an important problem for public health in endemic areas. In recent years, laparoscopic approaches have emerged as a valid alternative to open surgery and may offer possible advantages in terms of morbidity and convalescence. Methods & Materials: A prospective observational study was conducted at Avicenna Hospital Limited, Sirajganj from July, 2021 to June, 2024 on 50 patients with hepatic hydatid disease managed laparoscopically. Systematic analysis of patient demographics, clinical presentations, radiological characteristics, surgical techniques employed, intraoperative parameters, and postoperative outcomes was conducted. The four laparoscopic techniques employed were partial pericystectomy, cyst unroofing with omentoplasty, total pericystectomy, and simple drainage. Data were analyzed using SPSS version 26. Results: The mean age was 42.6±11.4 years with 56% males. Right upper quadrant pain was the most common presentation (78%). Single cysts were seen in 74% of patients and mostly in the right lobe (68%). Mean operative time was 96.4±21.8 minutes with a conversion rate of 6%. The overall complication rate was 20%, with bile leak being the most common complication (8%). No mortality was seen. Factors showing significant association with complications included cyst size ≥8 cm (p=0.01), presence of multiple cysts (p=0.03), biliary communication (p=0.004), and operative time ≥100 minutes (p=0.02). Mean hospital stay was 4.3±1.6 days. Conclusion: Laparoscopic management of hepatic hydatid disease is an effective and safe approach with acceptable complication rates and no mortality. Optimal outcomes require careful selection of patients and meticulous surgical technique. Larger size of the cysts, biliary communication, and longer operative time are the important risk factors for postoperative complications.