Laparoscopic Hydatid Cyst
In humans hydatid disease is caused by the larvae of a flat tapeworm, E granulosus. It is seen worldwide and is endemic in some areas, such as Australia and the Middle East, including Iran. The life cycle alternates between herbivores and carnivores—for example, sheep and dogs; man is an accidental intermediate host and an end point in the parasite's life cycle. The sheep ingests the egg and the egg hatches in the small intestine and the larval tapeworm burrows through the intestinal wall and travels to the liver via the blood. The hydatid cyst develops in the liver, lungs, brain, or other organ. When a dog eats the sheep viscera and ingests the hydatid cyst, the protoscolices attach to the small intestinal wall and the worms begin to form proglottids. Gravid proglottids, containing the eggs, detach from the end of the worm and spill their eggs into the lumen of the intestine. The eggs pass out in the faeces. Animals like cows and sheep become infected by eating the contaminated grass. Contaminated vegetables are the culprit in human infestations.
Cystic hydatid disease usually affects the liver (50–70%) and less frequently the lung, the spleen, the kidney, the bones, and the brain [1-3]. Liver hydatidosis can cause dissemination or anaphylaxis after a cyst ruptures into the peritoneum or biliary tract.
Hydatid cyst of the liver must be treated surgically.Albendazole 10 mg/kg/day for 3–6 weeks before surgery should be given to sterilise the cyst. During surgery special care should be taken not to spill the hydatid fluid. Precautions include packing the area with povidone iodine soaked sponges, aspiration of some of the hydatid fluid to reduce the tension, instillation of a scolicidal agent like hypertonic saline, and use of a suction cone.The pericyst is incised so that the hydatid cyst extrudes.
Laparoscopic surgery may be used for treating a variety of benign hepatic lesions in select patients. The anatomic locations of the lesions are more important than any other peculiarity when laparoscopic management is used. The procedure is feasible and safe, offering all the advantages of laparoscopic surgery.Laparoscopy considered as a safe and excellent approach for the treatment of hydatid cysts of the liver.