Comparative Study of Laparoscopic Versus Open Surgery in Management of Liver Hydatid Cyst

Background: Cystic echinococcosis is a chronic parasitic infection echinococcosis is caused by parasite called Echinococcus granulosus and Echinococcus multilocularis. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy. Due to the development in technology, laparoscopic surgery has been introduced for the surgical treatment of Hydatid Disease of the Liver (HD-L). The present study aimed to evaluate the clinical outcomes of laparoscopic versus open surgery for this disease in a comparative analysis.

Methods: Between January 2021 and November 2022, medical records of 144 patients who underwent surgery in Damascus university hospitals for HD-L were retrospectively analyzed. Patients’ demographic data, cystic features, operative details and postoperative outcomes were reviewed from the database. All patients were divided in two groups regarding the surgical approach; group A (open surgery, n=108) and group B (laparoscopic surgery, n=36)

Results: Both groups were similar regarding demographic variables and cystic features. In group B, mean operative time was significantly lower when compared to group A (50 minutes vs. 80 minutes, respectively p<0,01). Hospital stay was also lower in laparoscopic group (3.30 ± 0.7 vs. 7.11 ± 5.4 p<0,01). Overall postoperative complication was 19% and it was similar between groups. Incidence of biliary fistula was 16% in open and 11% in laporascopic.

Conclusion: Laparoscopic approach in the treatment of HD-L is safe and feasible. Additionally, it has some advantages including shorter operative time and hospital length of stay.