Comparison of Biliary Leakage between Laparoscopic Versus Open Surgery of Liver Hydatid Cyst: A Randomized Controlled Trial: Biliary Leakage between Laparoscopic Versus Open Surgery of Liver Hydatid Cyst

Muhammad Farrukh Aftab; Khurram Niaz; Hassan Abbas; Muhammad Hafeez Ullah; Khalid Javed; Laiba Anwar

doi:10.54393/pjhs.v6i8.1820

Authors

Muhammad Farrukh Aftab Torbay and South Devon Trust Foundation Hospital, Torquay, United Kingdom
Khurram Niaz Department of Surgery, Quaid e Azam Medical College, Bahawalpur, Pakistan
Hassan Abbas Department of Surgery, Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan
Muhammad Hafeez Ullah Department of Surgery, Nishtar Medical University, Multan, Pakistan
Khalid Javed Department of Surgery, Nishtar Medical University, Multan, Pakistan
Laiba Anwar Department of Surgery, Nishtar Medical University, Multan, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i8.1820

Keywords:

Hydatid Cyst Disease, Laparoscopic, Open, Surgery, Omentoplasty

Abstract

Hydatid cyst disease is challenging to treat, and surgery remains curative in the majority of cases. There has been more working done recently on laparoscopic Hydatid cyst disease surgery and comparing the outcomes with the open method. Objectives: To compare the frequency of post-operative outcomes vis. Biliary leakage, post-operative pain, wound infection rate, recurrence of Hydatid cyst disease, and length of hospital stay between open versus laparoscopic surgery in patients with liver Hydatid cyst disease. Methods: This randomized controlled trial was conducted in the Surgical Department of Nishtar Hospital, Multan. 84 patients were enrolled and underwent either laparoscopic or open conservative surgery with external drainage. Outcomes between the two groups in terms of biliary leakage, length of stay, pain, wound infection, and recurrence were compared. Statistical analysis was done using SPSS-25.0. Results: There was no significant difference present between groups in terms of biliary leakage (p=0.33), biliary leak output (p=0.21), and days till leak resolution (p=0.32). Biliary leaks occurred in 16.7% of cases in the open group. Pain scores were significantly lower in the laparoscopic group as compared to the open group (p=0.001). Wound infections occurred in 19% of cases in the open group and 4.8% cases in the laparoscopic group, and were significantly different (p=0.04). 2.4% cases had recurrences in both groups. Conclusions: Biliary leak rates between open and laparoscopic surgery for Hydatid cyst disease are comparable. Open surgery may have greater high-output biliary leaks. Advantages conferred by laparoscopic surgery are shorter length of hospital stay, fewer wound infections, and better pain control.

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