外科ジャーナル

Splenic Hydatid Cyst: Open Or Laparoscopic Approach?

Abstract

Eugen Târcoveanu*, Costel Bradea, Alin Vasilescu, Ștefan Georgescu, Mădălina Palaghia, Felicia Crumpei, Nicolae Danilă and Cristian Lupașcu

Splenic hydatid cyst is a rare disease. The aim of this study is to specify epidemiologic features, diagnostic tools, and therapeutic modalities of this disease.
Materials and methods: This is a retrospective study of 28 patients operated on by open and laparoscopic approach for a splenic hydatid cyst between January 1990 and December 2017 in First Surgical Clinic of "St. Spiridon" University Hospital of Iasi. The demographic data, localization, diagnosis, treatment methods, and the length of postoperative hospital stay of patients with splenic hydatid cysts were evaluated.
Results: Our study group included 16 women and 12 men with a mean age of 47.82 years. 17 patients had solitary splenic involvement and 11 patients had multiple organ involvement. Abdominal pain was the most common symptom. Splenomegaly was detected on physical examination in 12 patients. Ultrasound examination and CT scan revealed a cystic mass in the spleen in all cases. All patients were operated on by laparoscopic approach-6 cases (one conversion) and by open approach-22 cases: 26 total splenectomies and 2 conservative procedures for the spleen being performed. It is sometimes difficult to perform laparoscopic approach because of close adhesions with adjacent organs. No postoperative death was recorded, and the overall morbidity was 23.3%.
Conclusions: Splenic hydatid cysts are rare, being more common in endemic areas; in our region the incidence of splenic hydatid cysts is low. The splenic hydatid cyst may become a challenging surgical problem. The management must be individualized. Laparoscopic approach is feasible in selective cases.