Laparoscopic surgery for large hydatide liver cyst after two previous laparotomies.

Busić, Zeljko; Kolovrat, Marijan; Kopljar, Mario; Servis, Drazen; Cavka, Vlatka; Patrlj, Leonardo; Busić, Njegoslav; Cavka, Mislav; Nikolić, Igor

Laparoscopic surgery for hepatic echinococcosis is a technically difficult and demanding surgical procedure even for the most experienced abdominal surgeon. Surgery is performed after the conservative treatment with albendazole for 28 days. We report a case of laparoscopic partial pericystectomy with biliostasis and omentoplasty in a patient with two previously open surgeries (laparotomies)--right subcostal laparotomy for acute inflammation of the gallbladder and right pararectal laparotomy for perforated gangrenous appendix. The patient underwent extensive laparoscopic adhesiolysis due to pronounced intra-abdominal adhesions to gain access to a large hydatid cyst with the diameter of 11 cm. Laparoscopic surgery is much less traumatic to the patient with a better cosmetic effect.