Radiofrequency Energy in Hepatic Bed during Partial Cystectomy for Hydatid Liver Disease: Standing Out from the Usual Conservative Surgical Management

Abstract

Background. Surgical treatment of hydatid liver disease (HLD) is divided into conservative and radical procedures. While conservative techniques are easier and faster to perform, there is an emerging need to reduce their morbidity and recurrence rates. Our aim was to present and evaluate the efficiency and safety of the application of radiofrequency energy (TissueLink® and Aquamantys® systems) in hepatic bed during partial cystectomy. Materials and Methods. Eighteen consecutive patients with hydatid liver cysts were referred to our department between April 2006 and June 2014. Data about demographics, mortality, morbidity, and recurrence rate were obtained and analyzed retrospectively. Results. The mean follow-up was 38 months (range: 4–84 months). The postoperative course of most patients was uneventful. One case of recurrence was found in our series in a patient with 4 cysts in the right lobe, 3 years after initial treatment. He was reoperated on with the same method. Conclusions. Saline-linked RF energy seems to be an effective means to be employed in conservative surgical procedures of HLD, with satisfactory postoperative morbidity. Recurrence rates appear to be low, but further follow-up is needed in order to draw safer conclusions.

A Challenging Case of Refractory Biliary Leak in a Patient With Hydatid Liver Disease

“…To a lesser extent, HLD can be complicated by growth of the cyst and pressure on hepatic parenchyma or causing biliary obstruction [1,7]. The diagnosis of HD requires combination of clinical feature, serology and imaging [13]. Serologic tests that use the detection of hydatid antigen are employed to help in diagnosis, most common of which is enzyme-linked immunosorbent assay (ELISA) [14].…”

“…The diagnosis of HD requires combination of clinical feature, serology and imaging [ 13 ]. Serologic tests that use the detection of hydatid antigen are employed to help in diagnosis, most common of which is enzyme-linked immunosorbent assay (ELISA) [ 14 ].…”

“…First line of radiologic diagnosis is ultrasonography (USG). On USG, Gharbi et al described five types of echinococcal cysts and WHO described international classification in 2003 that those are believed to correspond to the evolution stage of hydatid cyst [ 7 , 13 , 15 , 16 ]. While CT scan is not essential for diagnosing HLD but gives higher definition in terms of cyst number, size, content and calcification [ 12 ].…”

Bronchobiliary fistula after hepatectomy: A case report and review of the literature

“…This may occur due to an obstruction of the biliary tract, trauma or hepatic abscess. Especially in endemic regions, hydatid or amebic disease of the liver are common causes of BB (2,3). The classic clinical presentation includes cough producing yellow sputum, known as bilioptysis, which represents a pathognomonic sign of BBF (4).…”

Operative technique in robotic pancreaticoduodenectomy (RPD) at University of Illinois at Chicago (UIC): 17 steps standardized technique

“…Named after Allen Oldfather Whipple, the surgeon who popularized it in North America in 1935 [ 6 ], PD had been described by the Italian Surgeon Alessandro Codivilla in 1898 and subsequently by the German surgeon Walther Kausch [ 7 ]. PD is a complex technique due to the combination of the dissection in close proximity to vital vascular structures and the reconstruction which usually requires three challenging anastomoses [ 2 , 8 , 9 ]. Such procedural complexity may lead to considerable morbidity.…”