Clinical and economic results of laparoscopic versus open surgery in the treatment of hepatic hydatid cyst; [Resultados clínicos y económicos de la cirugiá laparoscópica versus abierta en el tratamiento del quiste hidatídico hepático]

Abstract

Our country has a high prevalence rate of hydatid cyst. The present study, was performed in a national reference center, and it is the first Peruvian study to compare the clinical and economic results of surgical techniques for the treatment of this disease. Objective: To compare the clinical and economic results for laparoscopic surgery and open surgery in the treatment of hepatic hydatid cyst. Methods: The medical records of all patients who underwent open partial cystectomy and laparoscopic partial cystectomy (2013-2015) were retrospectively reviewed. Morbidity, mortality, recurrence, operative time, length of hospital stay, postoperative pain, and medical rest were evaluated. The costs per patient were found using the ABC costing system. Results: 22 patients were underwent open partial cystectomy (group 1) and 13 underwent laparoscopic (group 2). There wereńt differences in operative time, surgical complications, with postoperative morbidity of 27.3% (group 1) and 30.7% (group 2). The conversion rate was 18.7%. There wereńt cases of in hospital-mortality and one case of recurrence (4.5%) post open surgery. There wereńt differences between operative, postoperative and overall cost. Although the overall cost was lower for laparoscopic surgery (1 700.99 ± 1 195.82 USD for group 1 and 1 561.83 ± 702.53 USD for group 2) but without significant differences (p = 0.64). There was less postoperative pain, shorter hospital stay and duration of medical rest (p <0.05). Conclusion: The clinical and economic results were similar for both types of surgery; However, there was less post-operative pain, hospital stay, and quicker reintegration into working life for patients operated by laparoscopic surgery. © 2020 Universidad Ricardo Palma, Facultad de Medicina Humana. All right reserved.