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
ARTICLE HIGHLIGHTS
Research background

Hydatid disease of the liver is a prevalent problem in endemic areas, and surgery plays an important role in resolution. Although laparoscopic treatment is on the rise due to its increased accessibility, there are some limits that need to be addressed.

Research motivation

This study highlighted our experience in terms of the laparoscopic approach over the last 12 years, as well as the differences between the current laparoscopic experience and the previous one. Our aim was to showcase the improvements of the laparoscopic approach as well as its current limits.

Research objectives

This retrospective study compared the differences between open and laparoscopic approaches in terms of demographic data, preoperative assessment, intraoperative characteristics, and postoperative parameters, as well as follow-up, morbidity, and mortality, thus highlighting key aspects, differences, and the pearls and pitfalls of the laparoscopic approach in the treatment of this disease.

Research methods

In this retrospective cohort study, patients were divided into two groups, for which the differences were showcased based on the inclusion and exclusion criteria. The database consisted of all patients who had received surgical treatment for hydatid disease of the liver over an experience of 12 years.

Research results

Despite the fact that some of the exclusion criteria were dropped, there are still some issues regarding cyst location and cyst size that impose careful selection criteria. These selection criteria should be taken into account by inexperienced surgeons. Furthermore, some imaging criteria need to be instated in larger cysts.

Research conclusions

Based on our experience, the laparoscopic approach remains a safe, feasible approach which can be implemented in smaller volume centers, as long as some selection criteria are maintained. These selection criteria can be broadened; thus, more patients can benefit from this procedure, which accounts for better postoperative parameters, shorter postoperative hospitalization, and comparable morbidities and risks of recurrence with the open procedure.

Research perspectives

Based on our experience, the laparoscopic approach remains a safe, feasible approach which can be implemented in smaller volume centers, as long as some selection criteria are maintained. These selection criteria can be broadened; thus, more patients can benefit from this procedure, which accounts for better postoperative parameters, shorter postoperative hospitalization, and comparable morbidities and risks of recurrence with the open procedure.