The Laparoscopic Approach to Abdominal Hydatid Cysts
| Autor: | Amitai Bickel, Norman Loberant, Moshe Goldfeld, Arie Eitan, George Daud, Jonathan Singer-Jordan |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Echinococcosis Hepatic medicine.medical_specialty Adolescent parasitic diseases medicine Humans Cyst Prospective Studies Child Laparoscopy Emergency Treatment Pelvis Aged Cholangiopancreatography Endoscopic Retrograde Laparotomy medicine.diagnostic_test business.industry Perioperative Length of Stay Middle Aged medicine.disease Cannula Echinococcosis Surgery Endoscopy Treatment Outcome medicine.anatomical_structure Elective Surgical Procedures Abdomen Female business |
| Zdroj: | Archives of Surgery. 136:789 |
| ISSN: | 0004-0010 |
| DOI: | 10.1001/archsurg.136.7.789 |
| Popis: | Hypothesis The laparoscopic isolated hypobaric technique that we developed and use is safe and feasible for almost all kinds of hepatic and extrahepatic abdominal hydatid cysts. Design A case series. Patients Between August 1992 and December 1999, 31 patients with no selection criteria underwent 32 consecutive laparoscopic operations for 52 symptomatic hydatid cysts located in the liver (49), spleen (1), and pelvis (2). Eleven patients underwent surgery for between 2 to 5 cysts. Interventions The main surgical maneuvers (puncture, parasite neutralization, and complete evacuation) were performed through an assembled transparent cannula, in which a vacuum was created, while its tip adhered firmly to the cyst wall. Following evacuation of the cyst contents, we attempted to perform partial pericystectomy, omentoplasty, and closed-suction drainage. Main Outcome Measures Surgical complications and postoperative disease recurrence. Results Mean cyst diameter was 8.4 cm (range, 3.5-25 cm). Seven cysts were subdiaphragmatic, and 6 were on the posterior (hidden) aspect of the liver. Mean postoperative follow-up was 49 months. Forty-one cysts contained live parasites, and 11 were secondarily infected. Twenty-four cysts were complex. Perioperative complications occurred in 5 patients, including 1 patient who died 1 month after surgery owing to Candida sepsis. Mean hospital stay was 6 days. No evidence of recurrence was recorded during follow-up. Conclusions The isolated hypobaric laparoscopic technique described provides a safe and efficacious approach to almost all types of abdominal hydatid cysts and takes advantage of the recognized benefits of the laparoscopic approach. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|