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Male,healthy,34 y.o.,carrying a hydatid cyst of the liver.
Next week I intend to perform my second laparoscopic approach to a hydatid cyst of the liver,located in segment 4,next to the gallbladder,measuring 6x8x4 cms. approx.No signs of any complication : WCC normal,no eosinophilia,no jaundice,LTP normal,gallbladder USN,normal,CBD,5 mms.Chest X ray,normal,hemmaglutination +.
Approach:20
1.- 4 or 5 ports in accordance with the french technique.
2.- Isolation of the area with long gauzes soaked with saline solution 30%.
3.- Punction and instillation of same solution in the cavity through a gross trocar and after,empty of the contents using two wide aspiration cannules.
4.- Cholecystectomy + IOC to locate eventual biliary leakages.
5.- Closure of the cavity according to Posada's technique.
This,we did once in a 17 y.o. male and the outcome was uneventful...4 days in Hospital, no morbidity and follow up after two years, absolutely normal.
Please, any comments?