Minimally-invasive treatment of hepatic hydatid disease with Perforator-Grinder-Aspirator Apparatus and follow-up of 42 patients.

INTRODUCTION: The gold standard treatment for hydatid cyst (HC) is surgery. In surgical practice, open procedures still remain as the first option but in this minimally-invasive era, the frequency of laparoscopic procedures is increasing. The aim of this study is to evaluate the results of 42 patients with HC who underwent surgery with Perforator-Grinder-Aspirator-Apparatus (PGAA) and demonstrate the success and reliability of this technique.

METHODS: The datas of 42 patients, who underwent laparoscopic surgery with PGAA between Jan 2010 and Feb 2016 were evaluated retrospectively. All patients diagnosed with ultrasonography and underwent computed tomography to identify the surgical anatomy, accessibility of the cyst and the relation with the other cysts. All patients had 10 mg/kg/day albendazole treatment at least 10 days before surgery and preoperative antibiotic prophylaxis was made by 1 gr ampicillin/sulbactam.

RESULTS: Thirty-two patients had single cysts, 9 patients had 2 cysts and 1 patient had 3 cysts. Of the 53 cysts ; unroofing and drainage was performed to 38 cysts, unroofing-drainage and omentopexy were performed to 7 cysts and simple drainage was performed to 8 cysts. Four complications occurred after the procedure. The average duration of hospital stay was 4.73 ± 2.6 days.

DISCUSSION AND CONCLUSION: There are several treatment options in hydatid cyst and the most appropriate must be selected depending on the patient. We believe that the use of PGAA can increase the use of laparoscopy in cystic hydatidosis of liver and will achieve better results.