Laparoscopic Treatment in Children with Hydatid Cyst of the Liver

There is no consensus on the surgical treatment of children with hydatid cyst of the liver (HCL). We evaluated the outcomes of laparoscopic and open surgery for childhood HCL. We performed 81 open surgery and laparoscopic procedures in 37 (45.7%) boys and 44 (54.3%) girls with HCL (mean age 9.3 +/- 2.1 years) who were assigned to a main group (laparoscopy, n = 21) and a control group (open surgery, n = 60). Clinical assessments, surgical durations, complications, and postoperative outcomes were investigated. Cyst types in the two groups were I (Gharbi)/CE 1 (WHO-IWGE), 71.4 and 58.3%, respectively; II/CE 2, 19.1 and 25.0%, respectively; and III/CE 3, 9.5 and 16.7%, respectively. The parasitic hydatid cysts were located mostly in the right liver lobe in both the main and control groups (90.4 and 80.0%, respectively). Hospital stays were significantly (p < 0.05) longer in patients in the control group (12.1 +/- 1.5 vs. 5.6 +/- 2.2 days). Operation time was significantly (p < 0.01) shorter for the main group (90.1 +/- 7.8 vs. 120.6 +/- 5.3 min). Local complications (residual cavity infection, biliary fistula) occurred in 21.6% of patients in the control group and 14.3% in the main group. Each was treated, and none recurred. There were no apparent systemic complications. Laparoscopic surgical treatment for children with HCL is safe in compliance with all classic open surgery principles. The laparoscopic technique offered a shorter duration of the surgical effects and markedly fewer postoperative complications.