Pediatric hepatic hydatid cysts: recurrence risk factors following laparoscopic surgery-a 16-year cohort analysis.

Abstract

Background: Recurrence of hepatic hydatid cysts after laparoscopic surgery poses a significant challenge in pediatric patients. The administration of albendazole therapy pre- and post-operatively is proposed to reduce recurrence rates, yet its impact requires further investigation. This study aims to identify predictive factors associated with recurrence of hepatic hydatid cysts in children following laparoscopic surgery, focusing on cyst characteristics and perioperative albendazole therapy.

Methods: A retrospective cross-sectional analytical study was conducted using medical records of pediatric patients under 16 years of age who underwent laparoscopic surgery for hepatic hydatid cysts between 2006 and 2021. Collected data included patient demographics, cyst characteristics (size, location, and number), preoperative and postoperative albendazole therapy, surgical duration, and intraoperative complications. Logistic regression analysis was used to identify factors associated with cyst recurrence during the follow-up period, with statistical significance set at p < 0.05.

Results: A total of 152 pediatric patients were included, with a mean age of 7.9 ± 3.3 years. The recurrence rate was 12% (n = 18). In multivariate analysis, longer surgical duration (HR = 1.02; 95% CI 1.00-1.03; p = 0.013) and cysts located outside liver segment II (HR = 0.11; 95% CI 0.01-0.9; p = 0.039) were independently associated with recurrence. Albendazole therapy, administered pre- or post-operatively, was more frequent in the non-recurrence group but did not reach statistical significance. No cases of peritoneal hydatidosis were recorded during follow-up.

Conclusion: Key predictors of post-laparoscopy recurrence included extended surgical duration and cyst location. Although perioperative albendazole therapy was more frequent in the non-recurrence group, it did not reach statistical significance in reducing recurrence rates. These findings highlight the importance of tailored surgical approaches and careful postoperative monitoring to improve patient outcomes.