Laparoscopic management of hydatid cysts of liver in two different presentations: case reports

Hydatid cyst is a zoonotic infection caused by Echinococcus granulosus is mostly asymptomatic in humans till they progressively grow to larger masses mostly in liver lungs and spleen. Aim of this study is to study laparoscopic management of liver hydatid cyst (single and multiple) and combining it with most common laparoscopic procedure i.e. laparoscopic cholecystectomy. In case 1, a 23-year-old female presented with history of progressive epigastric fullness from last 1 year and dull abdominal pain since last 2-3 months. Ultrasound showed two hydatid cysts (one in each lobe of liver) and cholelithiais. She was managed laparoscopically for both pathologies and was discharged on drain on post-operative day 3. There were no perioperative complications. Post operatively drain was kept in view of biliary fistula which gradually reduced and stopped by day 3. This is the overall second case mentioned in literature and first case where cholelithiasis is managed along with two large hydatid cysts. In case 2, a 21-year-old male presented with complaint of dull aching pain abdomen and on evaluation was found to have a large cystic swelling originating from left lobe of liver and adherent to pericardial surface of diaphragm. He was operated laparoscopically and left subhepatic drain was placed in which, output was bilious for 4-5 days and was in decreasing trend. There was no other perioperative and post-operative complication. Laparoscopic surgery is becoming preferred modality in managing not only individual cases of abdominal hydatid cysts, but also along with other benign diseases like gall bladder.