A study on the clinical outcomes using different laparoscopic methods to treat hepatic cystic hydatidosis / 中华肝胆外科杂志

ABSTRACT

Objective To study the clinical outcomes using laparoscopic complete dissection of cysts,subtotal cystectomy and partial hepatectomy in the treatment of hepatic cystic echinococcosis.Methods A retrospective study was conducted on 40 patients with hepatic cystic echinococcosis treated by laparoscopic surgery from January 2014 to June 2018 at the First Affiliated Hospital of Xinjiang Medical University.According to the different surgical methods,these patients were divided into three groupsgroup A (n =14)the laparoscopic complete capsulectomy group,group B (n =14)the laparoscopic subtotal capsulectomy group,group C (n =12)the laparoscopic partial hepatectomy group.The operation time,intraoperative blood loss,time to pass first flatus,duration of drainage tube placement,days of hospitalization after operation,hospitalization expenses,complications of the residual cavity and local recurrence were compared among the 3 groups.Results In this study,all the 40 patients with hepatic cystic hydatidosis were cured,and no death occurred during the perioperative period.The intraoperative blood loss,postoperative duration of drainage tube placement,and hospitalization cost of the three groups were significantly the highest in group C (all P ＜ 0.05).The operative time and the time to pass first flatus in group C were both significantly greater than group B (P ＜ 0.05).The length of postoperative hospitalization in group A was significantly less than in group C (P ＜ 0.05).Postoperative recurrence and complications in group B were significantly worse than those in group A and group C (all P ＜ 0.05).Conclusion Laparoscopic complete dissection of the external capsule turned out to be the best laparoscopic treatment of hepatic cystic echinococcosis,followed by laparoscopic partial hepatectomy.Open surgery should be considered in patients with lesions which are evaluated preoperatively to have difficulty in carrying out laparoscopic complete dissection of capsule or partial hepatectomy.