Minimally invasive surgery for liver echinococcosis

Medzhidov R.T.; Sultanova R.S.; Aslanbekova M.R.; Shahnazarov M.A.

doi:https://doi.org/10.17116/hirurgia202509161

Medzhidov R.T.

Dagestan State Medical University

ORCID: 0000-0002-9662-6520

Sultanova R.S.

Dagestan State Medical University

ORCID: 0000-0002-0699-3483

Aslanbekova M.R.

Dagestan State Medical University

ORCID: 0009-0009-7214-9924

Shahnazarov M.A.

Dagestan State Medical University

ORCID: 0009-0002-2220-0698

Minimally invasive surgery for liver echinococcosis

Authors:

Medzhidov R.T., Sultanova R.S., Aslanbekova M.R., Shahnazarov M.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(9): 61‑68

DOI: 10.17116/hirurgia202509161

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To cite this article:

Medzhidov RT, Sultanova RS, Aslanbekova MR, Shahnazarov MA. Minimally invasive surgery for liver echinococcosis. Pirogov Russian Journal of Surgery. 2025;(9):61‑68. (In Russ.)
https://doi.org/10.17116/hirurgia202509161

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

OBJECTIVE

To analyze the effectiveness of minimally invasive surgery for small and medium sized liver cysts.

MATERIAL AND METHODS

We used minimally invasive technologies in 331 patients with echinococcal liver cysts (small cysts (<3.5 cm) — 49 (14.8%) cases, medium (3.5—7.0 cm) — 196 (59.2%), large (> 7.0 cm) — 86 (25.9%) cases). Conservative treatment was performed in 51 (15.4%) cases, percutaneous puncture treatment (PAIR, D — PA1 and PEVAK) combined with drug therapy — in 32 (9.7%), puncture and external drainage — in 90 (27.2%), open echinococcectomy via minimally invasive access — in 46 (13.9 %), cyst aplatization — in 57 (17.2%) cases. Minimally invasive resection technology was used in 55 (16.6%) patients.

RESULTS

Disappearance or scarring of cysts, shrinkage or structural change with complete resorption of liquid component were noted in 13 (25.5%) patients, no significant structural changes in the cyst (up to 3.5 cm) — in 27 (52.9%). Allergic manifestations occurred in 4 (12.5%) cases, complete regression of cyst — in 27 (84.4%), signs of suppuration — in 3 (9.4%), postoperative cystobiliary fistula — in 12 (13.3%) patients. Nine (10.0%) patients required cystpericystectomy via minimally invasive access. In cyst aplatization, conversion to mini-laparotomy took place in 2 (3.5%) cases, re-arrangement of ports — in 3 (5.3%), bile discharge through the drainage tube — in 2 (3.5%) cases. In resection technologies (n=55), re-arrangement of ports was necessary in 3 (5.4%) cases, intraoperative complications occurred in 3 (5.4%) cases, bleeding — in 3 (5.4%) patients. Postoperative specific complications were noted in 4 (7.3%) cases. Complications Clavien—Dindo type I were noted in 19 (55.8%) cases, type II — 1 (2.9%), IIIA — 5 (14.7%), IIIB — 9 (26.5%) cases. There were adverse events type IV and V. Recurrence of disease was observed in 27 (8.2%) patients.

CONCLUSION

One-stage total or subtotal echinococcectomy is the most effective surgery. Minimally invasive technologies are preferable for small and medium sized echinococcal liver cysts.

Keywords:

liver echinococcosis

minimally invasive surgery

radical treatment of liver echinococcosis

cystpericystectomy

liver resection

Authors:

Medzhidov R.T.

Dagestan State Medical University

ORCID: 0000-0002-9662-6520

Sultanova R.S.

Dagestan State Medical University

ORCID: 0000-0002-0699-3483

Aslanbekova M.R.

Dagestan State Medical University

ORCID: 0009-0009-7214-9924

Shahnazarov M.A.

Dagestan State Medical University

ORCID: 0009-0002-2220-0698

Received:

28.11.2024

Accepted:

06.02.2025

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References:

Medzhidov R.T., Sultanova R.S. Treatment and prevention of relapse of echinococcosis of the liver. Bulletin of surgery named after I.I. Grekova. 2020;179(2):26-32. https://doi.org/10.24884/0042-4625-2020-179-2-26-32
Musaev G.Kh., Levkin V.V., Sharipov R.Kh. Modern trends in the surgical treatment of echinococcosis of the liver. Sechenovsky Bulletin. 2018;4(34):78-84.
Solodova Yu.A., Fedosova O.A. Modern approaches to the diagnosis and treatment of liver echinococcosis. World science. 2019;5(26):645-648.
Sultanova R.S., Medzhidov R.T., Magomedova S.M. Modern approaches to the treatment of echinococcal disease. Clinical medicine. 2021;99(5-6):333-338.
Manterol C, Otzen T. Surgical strategies in the treatment of liver hydatid cyst. Surg Pract. 2017;21(4):164-172. https://doi.org/10.1111/1744-1633.12266
Amonov Sh.Sh., Bakhmonov D.A., Fayziev Z.Sh., Bokiev F.B., Turakulov F.A. Modern aspects of diagnosis and surgical treatment of echinococcosis of the liver. Bulletin Avicenna. 2019;21(3):480-488. https://doi.org/10.25005/2074-0581-2019-21-3-480-488
Khamidov M.A., Medzhidov R.T., Gasanov H.M. The main technological principles of laparoscopic echinococcectomy of the liver. Bulletin of DSMMA. 2019;2(31):226.
So Kouti M, Sadegni R, Pashazadeh S, Abadi SEH, Socouti M, Rezali-Hachesu P, Ghojazadeh M, Socouti BA. Systematic review and metanalysis on the treatment of liver hydatid cyst: Comparing laparoscopic and open surgeries. Arab J Gastro Enteral. 2017;18(3):127-135. https://doi.org/10.1016/j.ajg.2017.09.010
Abdisamatov B.S. Modern directions in the surgical treatment of echinococcosis of the liver. Modern medicine: Actual issues. 2016;42-43:91-98.
Amonov Sh.Sh., Prudkov M.I., Rakhmonov D.A., Fayziev Z.Sh. The results of minilaparotomic echinococcectomy from the liver with tools “Mini-Asistent. Healthcare Tajikistan. 2016;2:5-11.
Ivanov S.A., Kenerskaya M.V., Panfilov K.A. Optimization of methods of surgical treatment of hydrateic echinococcosis of the liver. Science and innovation in medicine. 2018;4(12):20-22.
Kalybekov T.A., Aliyev M.Zh. Surgical methods of treating liver echinococcosis (literature review). Bulletin of the Kyrgyz-Russian Slavic University. 2019;19(1):11-16.
Shirtaev Bakhytzhan, Sundetov Mukhtar, Kassenbayev Ruslan, Voronin Denis, Ismailova Gulziya. Single-center experience in the surgicae treatment of combined lung Echinococeosis. Saudi Ved J. 2018;39(1):31-37. https://doi.org/10.15537/smj.2018.1.21169
Gukov M.K., Kalmykov E.L., Zardakov S.M., Mukhabbatov D.K., Sadriev O.N. Echinococcosis of the liver: the role of computed tomography and morphological diagnosis of the state of liver tissue. The honey Biol Bulletin grew named after Acad. I.P. Pavlova. 2016;24(4):104-111.
Kolsanov A.V., Manukyan A.A., Zelter P.M., Chaplychin S.S., Kapishnikov A.V. Virtual modeling of liver operation based on computed tomography. Annals of surgical hepatology. 2016;21(4):16-22.
Magomedova S.M., Medzhidov R.T. Navigation technologies in the successful implementation of some laparoscopic operations. High-tech medicine. 2021;8(1):29-35.
Zelter P.M., Kolsanov A.V., Pyshkina Yu.S. Segmentation of focal liver formations and virtual resection based on computed tomography data. Bulletin of Siberian medicine. 2021;1:39-44.
Bektasoglu HK, Hasbahceci M, Tasci Vu, Aydogdu I, Umit Malya F, Kunduz E, Dolay K. Comparison of Laparoscopic and Conventional Cystotomy/Partial Cystectomy in Treatment of Liver Hydatidosis. Biomed Res Inf. 2019:1212404. https://doi.org/10.1155/2019/1212404PMCID:PMC6379859
Durleshter V.M., Kirtanasov Ya.P., Andreev A.V. The percutaneous treatment of patients with multi-chamber liver echinococcosis. Bulletin of Surgical Gastroenterology. 2018;1:23.
Kirtanasov Y.P., Ivshin V.G. Permanent interventions in the treatment of patients with multi -chamber hydrotidic echinococcosis of the liver. Bulletin of new medical technologies. Electronic edition. 2019;2:23-32.
Duta C, Pantea S, Lazar C, Salim A, Barjica D. Minimally invasive treatment of liver hydatidosis. JSLS. 2016;20(1):2016.00002. https://doi.org/10.4293/JSLS.2016.00002
Lotov A.N., Chernaya N.R., Bugaev S.A. and other saving surgery with liver echinococcosis. Annals of surgical hepatology. 2011;16(4):11-18.
Azizzova Z.A., Kurbonov K.M., Rizoev V.S. Small -invasive surgical interventions for echinococcosis of the liver. Bulletin Avicenna. 2019;21(1):116-120.
Novikov S.V., Rogaev M.L., Dzhagraev K.R., Boyarinov V.S. Minimum invasive methods of treating liver echinococcosis. Evidence gastroenterology. 2018;7(1):98.
Akhan O, Salik AE, Ciftci T, Akinci D, Islim F, Akpinar B. Comparison of Long-Term Results of Percutaneous Treatment Techigues for Hepatic Cystic Echinococcosis Types 2 and 3b. Am J Roentgenol. 2017;208(4):1-7. https://doi.org/10.2214/AJR.16.16131
Shera TA, Choh NA, Gojwari TA, Shera FA, et al. A Comparison of Imaging Guided Double Percutaneous Aspiration Injection and Surgery in the Treatment of Cystic Echinococcosis of Liver. Br J Radiol. 2017;90(1072). https://doi.org/10.1259/bjr.20160640