Laparoscopic simultaneous partial pericystectomy and total cystectomy for hydatid liver cysts – case report

Surgery remains the gold standard for the treatment of patients with echinococcosis, despite significant economic costs, advances in medical treatment and interventional radiology; in the past decades there has been a tendency toward laparoscopic surgery. We present a 66-year-old patient, from a rural area, who was admitted to our service complaining of spontaneous and palpatory pains in the right hypocondrium, headaches and dizziness. Abdominal CT scan highlighted 2 round calcified tumors, one of 7.2 cm diameter (VIII(th) segment) with liquid densities, and the other one localized higher, with a diameter of 2.3 cm (IV(th) segment). Under general anesthesia, after the neutralization of the content of the cyst with hypertonic saline irrigation, we performed laparoscopic partial pericystectomy of the VIII(th) segment liver cyst and total laparoscopic cystectomy of the IV(th) segment liver cyst. Postoperative evolution was favorable without biliary fistula formation, postoperative infections or cystic cavities abscesses. Laparoscopic surgery seems to be effective and safe for uncomplicated cysts in accessible segments of the liver, combined with adjuvant albendazole therapy to reduce complications and postoperative morbidity, but the procedure has its own disadvantages such as a limited area of surgical manipulation.