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Laparoscopic Treatment for Hydatid Cyst of the Liver

Authors:

Maja Odovic M.D, Dider Roulin M.D, Nermin Halkic PD MER

Correspondence to:

Maja Odovic M.D.

Department of Visceral Surgery

University Hospital of Lausanne (CHUV)

E-mail:           Maja.Odovic@chuv.ch
Didier Roulin M.D

Department of Visceral Surgery

University Hospital of Lausanne (CHUV)

E-mail:           Dider.Roulin@chuv.ch

Nermin Halkic PD MER

Department of Visceral Surgery

University Hospital of Lausanne (CHUV)

E-mail:           Nermin. Halkic@chuv.ch

This is a video of surgical technique for laparoscopic pericystectomie.  The video describes all the steps of the procedure and pays special attention to the pitfalls.

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Hydatid cyst of the liver develops as a result of infection with Echinococcus granulosus. The life cycle of Echinococcus granulosus includes a definitive host (usually dogs or related species) and an intermediate host (such as sheep, goats, or swine). Humans are incidental hosts; they do not play a role in the transmission cycle.After 10 to 12 months following infection, protoscolices are produced within the brood capsules. Cysts containing protoscolices are fertile and can produce daughter cysts, whereas cysts without protoscolices are sterile.External to the germinative layer is an acellular, laminated membrane of variable thickness. A host granulomatous reaction occurs around this membrane. The fibrous tissue reaction is known as the pericyst.Our patient was a 27 years old woman from Iraq, who was complaining of severe pain in the upper right quadrant of the abdomen. We did a CT scan that showed hydatid cyst situated in the segments V and VI of the liver. Serological tests confirmed the presence of Echinococcus granulosus.
Contraindications for this surgeries would be: - contraindication for pneumoperitoneum ( pulmonary disease such as COPD, restrictive pulmonary disease)
An intra-opérative ultrasound is highly recommended. One surgical device that cuts and coagulates at the same time is highly appreciated for the resection of the liver parenchyma.
We did a CT scan that showed hydatid cyst situated in the segments V and VI of the liver. Serological tests confirmed the presence of Echinococcus granulosus.
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The advantage of this surgical technique would correspond to the advantages of the laparoscopy over laparotomy well documented in the literature ( less pain, shorter hospital stay, lower ileus rate)
The patient didn't have any intra-operative complications. In the post- operative period she presented idiopathic postural hypotension with an unchanged haemoglobin level . The resolution was spontaneous and she was discharged from the hospital on the 7th post-operative day.
The autours decline all conflicts of interest, including financial.
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1. Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Vol. 114, Acta Tropica. 2010. p. 1–16. 2. Gomez I Gavara C, López-Andújar R, Belda Ibáñez T, Ramia Ángel JM, Moya Herraiz Á, Orbis Castellanos F, et al. Review of the treatment of liver hydatid cysts. World J Gastroenterol. 2015;21(1):124–31.

Review Laparoscopic Treatment for Hydatid Cyst of the Liver.

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