Laparoscopic treatment of hepatic hydatid disease.
ABSTRACT Hepatic hydatid disease is now rare in Australasia. However, it remains a significant problem in endemic areas. Many cases are now managed using minimally invasive techniques and this paper reviews the current status of laparoscopic approaches to hepatic hydatid disease.
A Medline data search was performed using the search terms of Ecchinococcos, laparoscopy, hepatectomy and pericystectomy. All publications from all publication years, including foreign language publications, were included.
Eight series have been published comprising five or more patients, with most utilizing techniques of laparoscopic cystectomy. All series managed Gharbi cyst types I-IV, and median operative times were between 60 and 82 min. Seven conversions were reported (3%) for problems with access or bleeding. There was one reported fatality, and between 5% and 45% (median 13%) of patients developed complications. Three cases of anaphylaxis were reported and 14 cases of bile fistula were reported (median incidence: 6%). Hospital stays were between 3 and 10 days (median stay: 3.5 days). Two series report recurrences (recurrence rates of 3% and 4%) and these were in patients not treated with preoperative albendazole.
Laparoscopic surgical techniques have been successfully applied to the treatment of hepatic hydatid cysts. While the uptake of these procedures is limited to areas of high prevalence and units with a specific interest, laparoscopic surgery is now one of the management options available to treat hepatic hydatid disease.
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ABSTRACT: Echinococcosis was described by Hippocrates more than two thousand years as a "fluid-filled liver", followed by the famous Arabian physician "Al-Rahzes." It is endemic in the Middle East, India, Africa, South America, New Zealand, Australia, Turkey and Southern Europe. The disease has got different clinical presentations, depending on the organ(s) involved, and may present a clinical dilemma regarding diagnosis and treatment. Surgery for hydatid cysts has been always considered as the treatment of choice; however, other options like chemotherapy, interventional and minimally invasive procedures or combination of all, are to be put into considerations as well In addition, selection of patients for any of these options is an important part of management. The disease might undertake a "malignant" course in the sense of high rate of recurrence, which further enforces the importance of meticulous evaluation and proper planning of treatment. In this communication, we critically reviewed the literature and present a brief summary of common clinical presentations, current methods of diagnosis, medical and surgical management, and follow-up strategy of Echinococcosis granulosus or Cystic Echinococcosis (CE).West African journal of medicine 25(2):144-52.
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ABSTRACT: Image-guided percutaneous treatments for echinococcal cysts were introduced in the mid-eighties. Today they represent a third therapeutic option, after surgery and benzimidazole derivatives. Two types of percutaneous treatments are available, based on the destruction of the germinal layer or the evacuation of the endocyst. To assess the extent of their use and their safety, a Medline search of the literature on this subject was performed. The number of cysts treated, their anatomical sites, the complications and, length of follow-up (when available), were all examined. The results show that percutaneous treatments for cystic echinococcosis are safe and efficacious in selected anatomical sites, provided basic safety issues are correctly addressed. However, before drawing final conclusions, a more detailed analysis of the literature is needed. Percutaneous treatments could be simplified and made more effective if a scolecidal agent could be found that melts the entire endocyst without causing harm to the biliary epithelium.Parassitologia 01/2005; 46(4):367-70.
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ABSTRACT: Hydatid disease of the liver is caused by the tapeworm Echinococcus granulosus, and the highest incidence of human infestation occurs in sheep and cattle-raising areas. Although, still an uncommon occurrence, it is being seen with increasing frequency; hence, it is important that surgeons make themselves aware of the pathology and treatment of the disease. The liver is most commonly involved, although many other organs, including lungs and brain may also be affected. An echinococcal cyst of the liver was reported in a patient who is a resident in Northern Ireland but had originally lived and worked in mainland Britain. Details of the lifecycle, pathology, diagnostic techniques and surgical management of hydatid cysts are reviewed.International Journal of Clinical Practice 06/2004; 58(5):479-82. · 2.43 Impact Factor