Tratamiento laparoscópico de los quistes hidatídicos hepáticos: técnicas y complicaciones postoperatorias / Laparoscopic treatment of hepatic hydatid cysts: techniques and post-operative complications

Introducción Análisis de nuestra experiencia en la intervención de quistes hidatídicos hepáticos mediante cirugía laparoscópica con criterios similares a los de la cirugía abierta. Material y métodos Estudio retrospectivo de 8 pacientes operados y de las complicaciones intraoperatorias y postoperatorias. Resultados En 7 pacientes se completó la intervención planificada por laparoscopia, en uno fue necesaria reconversión por hemorragia. Se realizaron 4 quistoperiquistectomías, 3 resecciones de cúpula saliente y 1 resección hepática. Dos pacientes sufrieron fístulas biliares: una de ellas (externa) necesitó una esfinterectomía endoscópica y la otra desarrolló un absceso que fue necesario reintervenir y drenar. En esta paciente se observó una trombosis de vena suprahepática derecha que se resolvió espontáneamente; 3 enfermos desarrollaron hipernatremia sin repercusión clínica. Conclusiones Muchas de las técnicas descritas en cirugía abierta son realizables por laparoscopia, sin necesidad de instrumentación específica para los quistes hidatídicos. Las complicaciones encontradas son similares a las de la cirugía abierta (AU)

Introduction We evaluate our experience in the surgical laparoscopic treatment of hepatic hydatid cysts with the same criteria that we use in open surgery. Material and methods A retrospective study of 8 operated patients and their intra- and postoperative complications. Results We performed the scheduled surgery on 7 patients; bleeding was the reason for conversion to open surgery in the remaining one. We made 4 complete peri-cystectomies, 3 de-roofing and 1 hepatic resection. Two patients had postoperative bile leaks: the first one had an external leak that needed an endoscopic sphincterotomy and the other developed an abscess that needed reintervention for drainage. This patient also had a right hepatic vein thrombosis that disappeared spontaneously. Finally, 3 patients had hypernatremia without clinical symptoms. Conclusions Many of the open surgery techniques for hepatic hydatid cysts can be performed laparoscopically, without any specific instruments. Our complications with laparoscopic treatment of hepatic hydatid cysts were similar to those of open surgery(AU)

[Laparoscopic treatment of hepatic hydatid cysts: techniques and post-operative complications]. / Tratamiento laparoscópico de los quistes hidatídicos hepáticos: técnicas y complicaciones postoperatorias.

INTRODUCTION: We evaluate our experience in the surgical laparoscopic treatment of hepatic hydatid cysts with the same criteria that we use in open surgery. MATERIAL AND METHODS: A retrospective study of 8 operated patients and their intra- and postoperative complications. RESULTS: We performed the scheduled surgery on 7 patients; bleeding was the reason for conversion to open surgery in the remaining one. We made 4 complete peri-cystectomies, 3 de-roofing and 1 hepatic resection. Two patients had postoperative bile leaks: the first one had an external leak that needed an endoscopic sphincterotomy and the other developed an abscess that needed reintervention for drainage. This patient also had a right hepatic vein thrombosis that disappeared spontaneously. Finally, 3 patients had hypernatremia without clinical symptoms. CONCLUSIONS: Many of the open surgery techniques for hepatic hydatid cysts can be performed laparoscopically, without any specific instruments. Our complications with laparoscopic treatment of hepatic hydatid cysts were similar to those of open surgery.