To evaluate the application value of laparoscopic hydatid cyst punture drainage with Trocar for hepatic cystic echinococcosis.

Clinical data of 20 patients with hepatic cystic echinococcosis treated with laparoscopic cyst punture drainage using disposable Trocar in Qinghai University Affiliated Hospital from January 2018 to January 2020 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 12 patients were male and 8 female, aged from 10 to 68 years, with a median age of 43 years. The hydatid cysts of 7 cases were located in the left lobe and 13 in the right lobe. 16 cases were with single lesion and 4 with multiple lesions. The median diameter of cysts was 10.3(1.0-18.2) cm. Under laparoscope, a 5-mm disposable Trocar was used to puncture the hydatid cysts through abdominal wall, and a common aspirator was inserted to discharge the cyst fluid for decompression. Hypertonic saline (20%) was injected through the Trocar inlet and soaked for 10 min. Different operations were performed on the patients according to different lesions. The operation results were observed.

The operations were completed successfully in all the patients without conversion to open surgery. Excision of internal capsule was performed in 9 cases, excision of internal capsule + dissection of partial external capsule in 6 cases, excision of internal capsule + dissection of partial external capsule + suture of bile leakage in 4 cases, multiple cyst resection in 1 case. Bile leakage occurred in 2 cases and residual cavity effusion in 2 cases after operation, and they were cured after drainage and anti-infection treatments. The remaining patients were properly recovered, and the drainage tube was removed after 3-7 d. The length of postoperative hospital stay was 7(3-12) d. During the postoperative follow-up for 3 months to 1 year, no recurrence or implantation metastasis was reported.

Laparoscopic hydatid cyst punture drainage with Trocar for hepatic cystic echinococcosis is an effective, safe and convenient method, which can prevent the fluid leakage and reduce the recurrent risk.