Rare as hen抯 teeth: laparoscopic management of primary pelvic hydatid cyst

Hydatid disease is a zoonotic parasitic disease most frequently caused by echinococcus granulose Primary peritoneal hydatidosisis very rare. We report a case of primary hydatid disease of the intraperitoneal pelvic space.A 22-year-old male patient presented with a history of abdominal pain since 5 months. Abdominal examination revealed a smooth, firm, mildly tender, non-mobile lump in suprapubic region, on digital rectal examination, a smooth spherical mass was felt anteriorly and laterally outside the rectal wall, rectal mucosa was normal. All routine investigations including liver function tests were within normal limits Computed tomography scan of the whole abdomen showed giant cyst of 10� cm with multiple well-defined cysts in rectovesical pouch.Diagnostic laparoscopy was performed. The liver, spleen, mesentery, omentum was found to be normal. A large tense hydatid cyst was noted in the pelvic cavity.Partial peri-cystectomy with endo-cystectomy was performed. Postoperative period was uneventful and patient was discharged on 4th postoperative day.Primary intra-abdominal but extra-peritoneal localization has been reported in only 0.2-2% cases making it a very rare entity.The treatment of choice for pelvic hydatid cyst is principally a careful surgical excision. Here with minimum invasive technique this case was operated and results were excellent

Hidatidosis múltiple: un desafío diagnóstico y terapéutico. Reporte de un caso clínico en el estado Monagas. / Multiple hydatid disease: a diagnostic and therapeutic challenge. Clinical case report in Monagas

Introducción: La hidatidosis, conocida también como equinococosis quística (EQ), es una zoonosis poco frecuente causada por el parásito Echinococcus, de la clase de los céstodos, del filio platelmintos. Se han descrito cuatro especies, los de importancia médica en humanos son: el Echinococcus multilocularis, Echinococcus vogeli y Echinococcus granulosus , este último responsable del 95% de los casos reportados de hidatidosis humana. Frecuentemente afectan la cavidad abdominal ubicándose en hígado, bazo, riñón, músculo y es poco común en retroperitoneo. Caso clínico : se trata de paciente masculino de 30 años, presentando dolor abdominal en hemiabdomen derecho, con limitación funcional de la marcha y estreñimiento, posterior a estudios de imágenes, se confirma patología compatible con hidatidosis abdominal en retroperitoneo derecho, se inicia tratamiento médico antiparasitario por un mes y luego se realiza resolución quirúrgica para resección de quiste retroperitoneal derecho, con buenos resultados. Conclusión : Este reporte debe su importancia a la escasa frecuencia con que se ha documentado esta patología en el país, sobre todo en la región oriental(AU)

Introduction: Hydatid disease, also knowns as echinococcosis, is an uncommon zoonosis frequently caused by the Echinococcus parasite, class cestodes, and phylum flatworms. Four species have been described, the ones with human medical relevance are multilocularis echuinococcus, vogeli echinococcus y granulosus echinococcus, last one being responsible for 95% of the human hydatidosis cases reported. They frequently affect the abdominal cavity, are located in the liver, spleen, kidney, and muscle, and rarely in the retroperitoneum.Clinical case : it is about a male patient, 30 years old, with symptoms for 3 years, feeling abdominal pain in right hemi-abdomen, ambulation disturbance, and constipation; after imaging tests is confirmed pathology compatible with Hydatid disease in right hemi-abdomen, Antiparasitic medical treatment was started for a month and then open surgical resolution was performed by resection of the right retroperitoneal cyst, with good results.Conclusion : This report owes its importance to the limited documented cases in the country, especially in the eastern region. It is also relevant because of the little-known special surgical technique used and the constant influx of foreigners in the country with unusual epidemiological pathologies that require treatment during their stay(AU)

Application and prospect of Bayesian spatio-temporal model in the study of hydatid disease / 中华地方病学杂志

With the development of computer technology and the abundance of spatio-temporal data, Bayesian spatio-temporal model (BSTM) has been developed rapidly, and wildly used by academics to investigate the spatial epidemiological feature of infectious diseases. Hydatid disease is a global natural focus disease that seriously endangers human health. Its epidemic process is complex and affected by many factors. BSTM provides a new method for study of hydatid disease. By modeling, we can not only analyze the influencing factors of hydatid disease, but also can predict the epidemic trend and make the disease distribution map, which is of great significance to public health decisionmaking. Based on a comprehensive review of the literatures, this paper expounds the principles, types and application status of BSTM in hydatid disease.

Intramuscular hydatid cyst in the lower extremity: report of three cases

Abstract Hydatid cysts are rarely detected in the muscle tissue, even in endemic countries. Echinococcus granulosis is the most common causative agent, whereas Echinococcus alveolaris is rare. Three patients, two females and one male, with primary echinococcosis of the skeletal muscles are described in this report. Mean patient age was 33.3 ± 14.6 years. The disease occurred as soft tissue masses in all three patients, and no hydatid foci were detected elsewhere in the patients. Skeletal muscle echinococcosis should be considered in the differential diagnosis of limb masses, especially in endemic countries.

Unusual hydatid cysts: cardiac and pelvic-ilio femoral hydatid cyst case reports and literature review

Abstract Introduction: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus, most commonly seen in the liver and lungs. The hydatid cyst is rarely seen in the heart and iliofemoral region, representing less than 2% of all cases. In this article, we report our cases of hydatid cysts in unusual loci. Methods: Between 2015 and 2018, 6 rare cases of hydatid cysts were diagnosed at the Cardiovascular Surgery Department of Harran University. Four of these patients had cardiac localization and two patients had their cysts located in the iliofemoral region, extending to the pelvic zone. All patients were female. Three patients had no other organ involvement. One patient with cardiac hydatid cyst underwent normothermic cardiopulmonary bypass + total pericystectomy + Cooley-like aneurysmectomy. Total pericystectomy was performed in three other patients with intrathoracic locus by normothermic cardiopulmonary bypass. Two patients who were referred to our clinic with palpable iliofemoral mass were evaluated with appropriate imaging methods and diagnosed accordingly. Multiple iliofemoral cysts were managed with pericystectomy and drainage by a single incision made over the inguinal ligament. Conclusion: Hydatid cyst disease can develop in cardiac chambers and inguinal region with or without hepatic or pneumatic involvement. Normothermic cardiopulmonary bypass can be safely used in patients with cardiac hydatid cysts, and capitonnage similar to ventricular aneurysm repair in patients with a widely involved cystic lesion can be very useful for the protection of ventricular functions.

Primary hydatid cyst of the pterygomandibular region: an unusual cyst, location and case report

Hydatid disease is a zoonotic infection in humans. The disease is endemic in some parts of the world, including Africa, Australia, and Asia, where cattle grazing is common; the disease is spread by an enteric route following the consumption of food contaminated with the eggs of the parasite. Failure to identify this parasite results in delayed diagnosis and increased morbidity to the patient. Upon diagnosis, every possible step should be taken, both surgical and medical, to prevent anaphylactic reactions from the cystic fluid. Postsurgical long-term follow up along with periodical ultrasonography of the liver and computed tomography scan of the abdomen is essential to rule out possible recurrence.

A Case Of Primary Pulmonary Echinococcosis Presenting As Left Sided Gross Pleural Effusion

Invasion of the human lungs by the larvae of the dog tapeworm Echinococcus granulosus (pulmonary cystic echinococcosis, PCE) is an incapacitating disease, frequently found across a wide geographic area, CE is endemic in many parts of the world, particularly the Mediterranean countries, Central Asia including the Tibetan Plateau, Northern and Eastern Africa, Australia, and South America. [1] Global burden of the human AE is approximately 18,235 new cases per annum with the majority (91%) occurring in China. [2] We report a case of 17–year–old girl student who presented with complaints of left sided pleuritic chest pain, fever and dyspnoea. X–ray chest PA view revealed gross pleural effusion on left side that was exudative in nature and did not respond to antibiotics and anti–tuberculous therapy. HRCT chest revealed large loculated cystic lesion showing calcification in left upper lobe parenchymal region suggestive of ruptured hydatid cyst. IgG antibody for E granulosus was positive. Ultrasound scan of abdomen and pelvis were within normal limits. A diagnosis of Primary pulmonary echinococcosis was made. She was treated successfully with Albendazole 400 mg bid for 21 days; six such cycles 14 days apart

Clinical characteristics and disease outcomes of 493 cases of hydatid disease / 实用医学杂志

Objective To investigate the demographical data,clinical data and outcomes of patients with Hydatid disease. Methods The data of 493 Hydatid disease patients collected from January 2013 to June 2017 in Qinghai Province were treated with the Epi Data 3.02 to record the data in duplicate and establish Hydatid disease database,which was then analyzed with SPSS 17.0 for statistical analysis.Results There were 409 cases of Cystic Echinococcosis and 84 cases of Bursal Echinococcosis. The male patients accounted for 42%,and the female for 58%.The curative rate of CE2 and CE4 patients was higher than that of patients with CE1,CE3 and CE5,with sig-nificant differences(χ2=3.502,Р=0.835).The cure rate of patients with cystic echinococcosis was significantly higher than that of Bursa edulis(χ2=30.275,Р=<0.01).The difference was statistically significant in view of the affected position(χ2= 17.521,Р = 0.020). In view of Child-Pugh classification and immunological examination on the outcome of the disease,the difference was statistically significant(χ2= 17.521,Р = 0.020;χ2= 15.731,Р < 0.022). In view of the operation method,the different was statistically significant(χ2= 57.389,Р < 0.01). Conclusion The data of Hydatid disease patients in Qinghai province were establisheded,which provides scientif-ic and detailed and clinical data on Hydatid disease.

Resultados del tratamiento laparoscópico de los quistes hidatídicos hepáticos no complicados / Results of laparoscopic treatment of uncomplicated hepatic hydatid cysts

Introducción: La cirugía es el tratamiento más efectivo para los pacientes portadores de quistes hidatídicos hepáticos (QHH). Actualmente no existe consenso si la cirugía abierta o laparoscópica es la mejor vía de tratamiento. El objetivo del presente estudio es describir la técnica quirúrgica y los resultados de la cirugía radical (periquistectomía) por vía laparoscópica. Materiales y métodos: Estudio de cohorte no concurrente. Se incluyeron a los pacientes portadores de QHH no complicados en los que se realizó periquistectomía radical laparoscópica entre los años 2007 y 2015 en el Hospital Clínico de la Pontificia Universidad Católica de Chile. Se consignaron variables demográficas, clínicas, características del QHH, morbimortalidad y recurrencia en el seguimiento. Resultados: Se operaron 24 pacientes. La mediana de edad fue de 35 años (3-79). La mediana de tamaño del QHH fue de 8 cm (3-15). Las complicaciones postoperatorias se presentaron en 4 casos (16%); un paciente presentó una fístula biliar (4,1%). No hubo mortalidad en este estudio y la estadía hospitalaria fue de 3 días (2-25). La mediana de seguimiento fue de 57,5 meses (9-106); se observó un caso de recurrencia a nivel hepático que requirió otra cirugía. Conclusiones: El tratamiento radical de los QHH no complicados por vía laparoscópica es factible y seguro; al compararlo con la literatura existente no se aprecian diferencias en la morbimortalidad ni recurrencia.

Introduction: Surgery is the most effective treatment for patients with hepatic hydatid cysts (HHC). Currently there is no consensus whether open or laparoscopic surgery is the best treatment. The aim of this study is to describe the surgical technique and the results of laparoscopic radical surgery (pericystectomy). Material and methods: Non-concurrent cohort study. We included patients with uncomplicated HHC in which it was performed a laparoscopic radical pericystectomy between 2007 and 2015 at the Clinical Hospital of the Pontificia Universidad Catolica de Chile. Demographic and clinical variables, HHC characteristics, morbi-mortality and recurrence at follow-up were recorded. Results: Twenty-four patients were operated. The median age was 35 years (3-79). The median HHC size was 8 centimeters (3-15). Postoperative complications occurred in 4 cases (16%); one patient had a biliary fistula (4.1%). There was no mortality in this study and the hospital stay was 3 days (2-25). Median follow-up was 57.5 months (9-106); a case of hepatic recurrence requiring another surgery was observed. Conclusions: The radical treatment of uncomplicated HHC by laparoscopic surgery is feasible and safe; when compared with existing literature there is no differences in morbi-mortality or recurrence.

Hidatidosis cerebral: comunicación de seis casos pediátricos / Cerebral hydatid disease: report of six pediatric cases

Hydatid disease is a parasitic infection whose etiologic agent is Echinococcus granulosus. Human is an accidental intermediate host and the most common site is the liver. The brain involvement is unusual and up to 75% of cases are described in the pediatric population. We present six children with cerebral hydatid disease admitted to the Pediatric Hospital J.P. Garrahan. All had neurological involvement on admission. The images showed single cystic lesion in the brain. They did not present involvement in other organs. Serology was negative in all cases. Medical and surgical treatment in all cases. The clinical outcome was favorable without sequelae in five of them and one had a residual paresis right faciobrachiocrural. This infection should be considered in the differential diagnosis of cystic tumor lesions of the central nervous system.

La hidatidosis es una infección parasitaria causada por Echinococcus granulosus. El ser humano es un hospedero intermediario accidental. La localización más frecuente es la hepática. El compromiso cerebral es inusual, se describe que hasta 75% ocurre en población pediátrica. Se presenta una serie de seis niños con hidatidosis cerebral internados en el Hospital de Pediatría J. P. Garrahan. Todos presentaron compromiso neurológico al ingreso. Las imágenes mostraron lesiones quísticas únicas en el cerebro. No tuvieron compromiso de otros órganos. La serología fue negativa en todos los casos. El tratamiento fue médico-quirúrgico. La evolución clínica fue favorable sin secuelas en cinco de ellos y uno presentó una hemiparesia faciobraquiocrural derecha como secuela. Esta infección debe considerarse entre los diagnósticos diferenciales de lesiones tumorales quísticas del sistema nervioso central.

Application of ERCP in treatment for biliary complications of hepatic hydatid disease / 中国内镜杂志

Objective To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in treatment for biliary complications of hepatic hydatid disease. Methods From October 2010 to October 2016 , 27 patients who were admitted for hepatic hydatid disease underwent therapeutic ERCP pre- or post-operation, then we retrospectively analyzed the clinical manifestations, laboratory tests, imaging examinations, ERCP methods and therapeutic effects in perioperative period of ERCP. Results All the 27 patients who underwent ERCP pre-or post-operations because of biliary complications of hepatic hydatid disease obtained good treatment effect. There were some reasons for ERCP, 12 cases for acute suppurative cholangitis and obstructive jaundice caused by intrabiliary rupture and 7 for severe jaundice compress by large hepatic hydatid cyst, whereas 6 cases for biliary fistula and 2 for biliary stricture after operation. 6 indexes including white blood cell count (WBC), aspertate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) were significantly different between 24 hours pre- and 48 hours post- ERCP (P < 0.05), all the patients were improved after operation. Conclusion ERCP which is performed at pre- or post- operation may be an effective treatment for biliary complications of hepatic hydatid disease such as acute suppurative cholangitis, biliary fistula and stricture.

Treatment efficacy and safety of ultrasound-guided puncture combined with surgical resection for liquefied cavitary hepatic alveolar echinococcosis / 中华肝胆外科杂志

Objective To study the safety and efficacy of ultrasound-guided puncture combined with surgical resection for liquefied cavitary hepatic alveolar echinococcosis (HAE).Methods A retrospective study was conducted on 17 patients who had liquefied cavitary HAE and were treated at the Affiliated Hospital of Qinghai University from January 2014 to August 2016.Ten patients were treated with ultrasound-guided puncture combined with surgical resection (the case group),and 7 patients were treated with resection (the control group).The basic characteristics,operation time,blood loss during operation,preoperative and postoperative laboratory tests and complications were compared between the 2 groups.Results There were no significant differences between the 2 groups in basic characteristics,such as age,gender,and lesion diameter (P ＞ 0.05).The operation time and blood loss during operation showed significant differences between the 2 groups,(308.0 ± 23.0) min (389.0 ± 95.7) min and (1 360.0 ± 182.9) ml vs.(1 607.1 ± 205.0) ml,respectively (all P ＜ 0.05).The prothrombin time (PT) after day 3 of operation and alanine aminotransferase level after day 5 of operation showed significant differences between the 2 groups,(13.8 ±0.9) s vs.(15.5 ±1.7) s and (81.9 ±20.9) U/L vs.(108.1 ±29.5) U/L,respectively (all P ＜ 0.05).There was no significant difference in postoperative complications between the 2 groups.Conclusions Ultrasound-guided puncture combined with surgical resection shortened the operation time,reduced blood loss and avoided serious complications after surgery.This treatment is efficacious and safe for liquefied cavitary HAE.

"Double ""T"" tube drainage in hepatic echinococcosis which ruptured into the common bile duct" / 中华肝胆外科杂志

Objective To investigate the double T tube drainage method in the treatment of hepatic echinococcosis which ruptured into the common bile duct.Methods A retrospective study was conducted on 86 patients who were treated surgically for hepatic echinococcosis which had ruptured into the common bile duct at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to December 2014.The average postoperative hospitalization,postoperative complications (residual cavity bile leakage and residual cavity effusion,residual cavity infection) and biliary complications of biliary tract infection were analyzed.Results Significant differences were found on the postoperative residual cavity complications in group A:(2,7.1％) when compared with Group B:(9,15.5 ％),and also on the postoperative hospitalization between the double T tube drainage group [group A:(7.1 ± 1.3) d] and the traditional T type tube decompression group [B group:(8.2 ± 1.5) d] (P ＜ 0.05).Conclusions The doubleT tube drainage in the treatment of hepatic echinococcosis which had ruptured into the common bile duct was simple,safe and effective.This treatment could completely cure residual cavity bile leakage,and it had the advantage of avoiding occurrence of common bile duct related complications caused by the traditional suture method for bile leakage.

Ultrasonic differential diagnosis of patients with liver alveolar hydatid disease and hepatic malignant tumor / 中华地方病学杂志

Objective To investigate the value of ultrasound contrast in differential diagnosis of liver alveolar hydatid disease and hepatic malignant tumor.Method Totally 36 cases of liver alveolar hydatid disease and 31 cases of hepatic malignant tumor were retrospectively analyzed,who visited the Ultrasound Department of Qinghai Red Cross Hospital from March 2010 to September 2013,the performance characteristics of gray-scale ultrasound and contrast-enhanced ultrasound (CEUS) on hepatic malignant tumor and liver alveolar hydatid disease were compared.Results Gray-scale sonography of 36 liver alveolar hydatid diseases showed clear boundary,heterogeneous hypoechoic nodules,and the maximum area was (5.06 ± 2.46) cm2 in 49 lesions;gray-scale sonography of 31 hepatic malignant tumors showed unclear boundary,hypoechoic nodules,and the maximum area was (7.29 ± 5.83) cm2.CEUS of liver alveolar hydatid disease showed non-enhancement in three phases,and rim enhancement was seen synchronized with the liver parenchyma.CEUS of hepatic malignant tumor showed hyperenhancement in arterial phase,equal-enhancement or hypo-enhancement in portal phase and delayed phase,and abnormal perfusion areas were clear.Conclusion Liver alveolar hydatid disease is different in the performance of CEUS from hepatic malignant tumor,CEUS has a great value in the differential diagnosis of liver alveolar hydatid disease and hepatic malignant tumor.

Evaluation on application of China Disease Prevention and Control Informa-tion System of Hydatid Disease Ⅱ System integration and simulation tests / 中国血吸虫病防治杂志

Objective To report the integrated progress of the hydatid disease information management system,and to pro-vide the reference for further system improvements by analysis of results on simulation test feedback. Methods The work of in-stitutional code matching by collecting fundamental and integrated information of the system in epidemic areas of hydatid disease was carried out,and professional control agencies were selected to carry out the simulation test. Results The results of agen-cies code matching at stage indicated the average completion rate was 94.30% on administrative agencies,69.94% on registered professional agencies and 56.40% on professional institutions matching related to hydatid disease prevention and control imple-ments in seven provinces(autonomous regions)and Xinjiang Production and Construction Corps. Meanwhile,the response rate of open-ended proposals was 93.33% on fifteen feedbacks,and the statistics showed 21.43% believed the system was low fluen-cy,64.29% considered the system was inconvenience for data inputs and 42.86% considered it would be improved on system sta-tistics functions,of which 27.78% were provincial users,22.22% were the city users and 50.00% were the county users. Con-clusion The hydatid disease prevention information management system meets the fundamental needs of the majority agencies in hyperendemic areas of echinococcosis,it needs to develop the further test with more agencies joining after the work of the in-stitutional code matching completion and the system service improvement in the next stage.

Primary Giant Splenic and Hepatic Echinococcal Cysts Treated by Laparoscopy

Cystic echinococcosis is a zoonosis caused by the larval stage of Echinococcus granulosus. Liver and lungs are the most commonly affected organs whereas splenic infection is rare and its primary involvement occurs in less than 2% of cases. We report a case of primary giant splenic and hepatic hydatid cyst in a 28-year-old woman who was admitted for upper right quadrant pain. The abdominal ultrasonography and computed tomography showed two cystic tumors with hydatid features in liver and spleen. Total splenectomy was performed for the splenic cyst and partial pericystectomy with drainage for the liver cyst using a laparoscopic approach. One drain was kept in place for two months due to a biliary leak of about 20 ml/day and removed afterward. The patient was discharged on postoperative day 7. Laparoscopic approach for patients with concomitant splenic and hepatic hydatidosis is a safe and effective option.

Control programme for cystic echinococcosis in Uruguay

Cystic echinococcosis is a highly endemic parasitic zoonosis that is present in the Southern Cone countries of America. For several decades, various prevention and control programmes have been implemented in different countries and regions, with varying results. In Uruguay, a new control programme was implemented in 2006 that employed new strategies for canine diagnosis and treatment, dog population control, diagnosis in humans, epidemiological surveillance, and health education, including community participation. The control programme in Uruguay addresses the control and surveillance of the disease from a holistic perspective based on Primary Health Care, which has strengthened the community’s participation in developing and coordinating activities in an interdisciplinary manner. Similarly, the control programme that is currently implemented is based on a risk-focused approach. The surveillance and control measures were focused on small villages and extremely poor urban areas. In this study, the strategies used and the results obtained from 2008-2013 are analysed and discussed.

Complete Resolution of Bilateral Pulmonary Hydatid Cysts with Prolonged Administration of Albendazole: A Rare Occurrence

Hydatid disease is a zoonotic disease caused by Echinococcus species. Echinococcus granulosus is the most common species which is responsible for hydatid disease in the humans who act as accidental intermediate hosts in the life cycle of the parasite. Pre-operative albendazole therapy followed by surgery is the mainstay of treatment for pulmonary and hepatic hydatid cyst at present. Not much data is available to support the sole use of albendazole for complete cure apart from its usage for those patients who have refused surgery or cannot undergo surgery because of any reason. We hereby report the case of a 12 year old female patient who was diagnosed with bilateral pulmonary hydatid cysts that responded well to Albendazole 15mg/kg /day given for a period of nine months with a drug free interval of one week every month. There was complete clinical and radiological resolution of hydatid cyst after the treatment. There has been no recurrence on follow-up of one year.

Hydatid cystic disease at unusual sites

Hydatid disease is a zoonotic infection caused by Echinococcus granulosus, which belongs to phylum Platyhelminthes. It is endemic in many parts of the world including India. Though Hydatid disease commonly occurs in liver and lung no organ or tissue is immune in the body. When it presents in unusual sites Hydatid disease often poses a diagnostic challenge. A high index of suspicion, comprehensive radio imaging investigations are often required to evaluate these cases. In the study we have conducted for 4 years, we reported a total no of 7 Hydatid cases that presented at unusual sites. Most common rare presentation in our study was renal hydatid disease, 3 cases; and one each in pancreas, Spleen, peritoneum and pelvis.

The impact of combined laparoscopic and choledochoscopic treatment on biliary leak in hepatic hydatid disease in a high attitude region / 中华肝胆外科杂志

Objective To explore the impact of combined laparoscopic and choledochoscopic treatment on bile leak in hepatic hydatid disease at a high attitude region.Methods The clinical data of 50 patients who underwent combined laparoscopic and choledochoscopic treatment were compared with 50 patients who underwent laparoscopic surgery alone for hepatic hydatid internal capsule excision surgery.Results In the combined laparoscopic and choledochoscopic group,the incidence of biliary fistula after surgery was 15％,the incision infection rate was 13％,the length of hospitalization was (11.6 ± 3.8) days and the postoperative time to take off drain was (14.3 ± 7.9) days.These were significantly better than those in the laparoscopic alone group.The operation time in the former group was (108.2 ± 28.4)min,which was slightly longer than the laparoscopy group.Conclusion The combined laparoscopic and choledochoscopic treatment is a safer therapeutic option in treating hepatic hydatid disease with less trauma,faster recovery and shorter hospital stay than laparoscopic surgery alone in a high attitude region.