Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2023; 15(5): 847-858
Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.847
Surgical management of hydatid cyst disease of the liver: An improvement from our previous experience?
Florin Zaharie, Dan Valean, Roxana Zaharie, Calin Popa, Emil Mois, Diana Schlanger, Alin Fetti, Claudiu Zdrehus, Andra Ciocan, Nadim Al-Hajjar
Florin Zaharie, Dan Valean, Calin Popa, Emil Mois, Diana Schlanger, Alin Fetti, Andra Ciocan, Nadim Al-Hajjar, Department of Surgery, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
Roxana Zaharie, Department of Gastroenterology, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
Roxana Zaharie, Department of Gastroenterology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca 400012, Cluj, Romania
Claudiu Zdrehus, Department of Anaesthesiology, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400636, Cluj, Romania
Author contributions: Zaharie F designed the original report; Vălean D and Zaharie R contributed to data collection and analyses; Popa C, Schlanger D, Fetti A, and Ciocan A reviewed the literature; Moiș E and Zdrehuș C contributed to revising the manuscript; Zaharie F and Al-Hajjar N reviewed and approved the final manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The Institutional Review Board of the Regional Institute of Gastroenterology and Hepatology “O. Fodor” Cluj-Napoca provided approval for this study (IRB No. 8483).
Informed consent statement: All patients included in the study had provided written informed consent for participation in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Current data is available at the Regional Institute of Gastroenterology and Hepatology “O. Fodor” - at the Human Resources and Statistics department.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roxana Zaharie, MD, PhD, Lecturer, Department of Gastroenterology, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor 19-21 Street, Cluj-Napoca 400636, Cluj, Romania. zahariedeliaroxana@gmail.com
Received: December 3, 2022
Peer-review started: December 3, 2022
First decision: December 26, 2022
Revised: January 12, 2023
Accepted: March 24, 2023
Article in press: March 24, 2023
Published online: May 27, 2023
Abstract
BACKGROUND

Hydatid liver disease remains an important issue in endemic areas, which may require immediate surgery. Although laparoscopic surgery is on the rise, the presence of certain complications may require conversion to the open approach.

AIM

To compare the results of laparoscopic treatment and the open approach in the context of a 12-year single institution experience, and to perform a further comparison between results from the current study and those from a previous study.

METHODS

Between January 2009 and December 2020, 247 patients underwent surgery for hydatic disease of the liver in our department. Of the 247 patients, 70 underwent laparoscopic treatment. A retrospective analysis between the two groups was performed, as well as a comparison between current and previous laparoscopic experience (1999-2008).

RESULTS

There were statistically significant differences between the laparoscopic and open approaches regarding the cyst dimension, location, and presence of cystobiliary fistula. There were no intraoperative complications in the laparoscopic group. The cutoff value for the cyst size regarding the presence of cystobiliary fistula was 6.85 cm (P = 0.001).

CONCLUSION

Laparoscopic surgery still plays an important role in the treatment of hydatid disease of the liver, with an increase in its usage over the course of years that has shown benefits regarding the postoperative recovery with a decreased rate of intraoperative complications. Although experienced surgeons can perform laparoscopic surgery in the most difficult conditions, there are some selection criteria that need to be maintained for higher quality results.

Keywords: Follow-up, Cystobilliary communication, Conversion, Postoperative complications, Imaging

Core Tip: Laparoscopic surgery for the treatment of liver hydatid disease has grown significantly in the last decade, due to increased accessibility and better training. Although, some limits were reported on previously regarding the cyst size, location, and presence of complications such as cystobiliary fistulas. This article discusses our experience over 12 years in the surgical treatment of hydatid liver disease, highlighting key aspects of surgical timing as well as differences between the open approach and laparoscopic approach in terms of case selection, comorbidities, and postoperative management.