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

Export Objective: Cystic echinococcosis is a chronic parasitic infection. Echinococcosis is caused by parasites called Echinococcus granulosus and Echinococcus multilocularis. The modern treatment of hydatid cysts of the liver varies from surgical intervention to percutaneous drainage or medical therapy. Due to the development of 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 2014 and March 2019, the medical records of 166 patients who underwent surgery at 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 into two groups regarding the surgical approach: Group A (open surgery, n=138) and Group B (laparoscopic surgery, n=28). Results: Both groups were similar regarding demographic variables and cystic features. In group B, the mean operative time was significantly lower when compared to Group A (89±28 minutes vs. 144±19 minutes, respectively, P < 0.01). Hospital stay was also lower in the laparoscopic group (3.38±0.7 vs. 8.81±5.4, P < 0.01). Overall postoperative complication was 19%, and it was similar between groups. The incidence of biliary fistula was 15% (n=26). Conclusions: The Laparoscopic approach to the treatment of HD-L is safe and feasible. Additionally, it has some advantages, including shorter operative time and length of hospital stay.