Background : Because of limited experience, controversies still exist about the laparoscopic management of hepatic hydatid cysts. In this study, we are presenting our early experience with this new technique of endoscopic-assisted laparoscopic management of hepatic hydatid cyst compared with open surgery.
 
Patients and Methods: Between January 2000 and July 2010 fifteen patients (12 males and 3 females) with hepatic hydatid cysts were referred from gastro-entrology unit at National Hepatology and Tropical Medicine Research Institute. All patients had a single, large hepatic hydatid cyst. Patients received a preoperative course of Albendazole for one month. Six patients underwent open surgery and nine patients underwent EAL technique. All patients in the EAL group had pre-operative ERCP to rule out any biliary communication. Operative time, hospital stay, post-operative complications and follow-up were recorded.
 
Results:  Mean operative time was 206 minutes in the open surgery group compared with 110 minutes in EAL group. The mean hospital stay was 22.3days in open group and 8days in EAL group. All patients required insertion of intra-abdominal drain. At a maximum follow-up of 9 years, only two patients developed post-operative bile leak in the open group and treated conservatively.
 
Conclusion: We concluded that endoscopic-assisted laparoscopic technique is a safe, simple and promising methods with a potentially low risk of intra-abdominal spillage compared with open surgery.