Primary Localization of a Hydatid Cyst in the Pancreas via Laparoscopic Treatment: A Case Report

Abstract

Hydatid disease is mainly because of the Echinococcus granulosus at the larval stage. The liver and lung are its most consequences. The pancreatic hydatid cyst (PHC) incidence is very low (0.14%-2%). A 55-year-old female patient presented with epigastric pain for the last one year that the pain did not continue but during one months ago suffered continually. In physical examination, there was not any abdominal bulb, tenderness and rebound tenderness. A 54×59 mm cystic structure was observed by ultrasonography (USG) and Contrast-enhanced Computed Tomography (CT) in the pancreatic body with stone in the gallbladder. Amylase, lipase, and LFT levels were normal. The Anti-hydatid antibody was positive. During laparoscopic exploration, a hydatid cyst was found. Partial cystectomy with external drainage and cholecystectomy was performed once irrigation with scolicidal agent and evacuation of cystic contents was conducted. Histopathological biopsy reported Hydatid cyst. A pancreatic, hepatic cyst is a rare event. Hematogenous is the most common spread way. Cysts in the pancreatic head could be found with obstructive jaundice. Usually, cysts in the body and tail are known to be asymptomatic. USG, CT, and Hydatid serology are useful with the clinical diagnosis as well as monitoring the recurrence. An exploration via surgery is an option that includes pericystectomy, partial cystectomy with/without external drainage or omentopexy, marsupialization, or cysto-enterostomy, which is done. What makes this case unique is the laparoscopic method that we used instead of open surgery, which is a treatment of choice. The recommendation is pre-operative and postoperative antihelminthic (Albendazole). PHC could be present as pseudocyst or cystic neoplasm of the pancreas. For patients with endemic regions and laparoscopic surgery, differential diagnosis of the cystic pancreatic lesion should be noticed. Common surgery approach could be considered for such patients.