Multiple Giant Hepatic Hydatid Cysts Managed Laparoscopically: A Case Report

Abstract: Laparoscopic surgery for hepatic hydatid disease is increasingly used, although multiple giant bilobar cysts remain technically challenging because of exposure difficulties and the risks of spillage, biliary leakage, and recurrence. We report the case of a 47-year-old male farmer from an endemic area who presented with right upper quadrant heaviness. Imaging showed multiple giant bilobar hepatic hydatid cysts with segmental portal hypertension, and serology was positive. After 4 weeks of albendazole, he underwent laparoscopic controlled puncture-evacuation, partial cyst wall resection, hemostasis, epiploplasty, and drainage. Postoperative recovery was uneventful, with no biliary fistula, discharge on postoperative day 5, and no recurrence on 6-month CT follow-up after 3 months of albendazole. This case highlights that laparoscopic conservative surgery can be feasible and effective in selected patients with multiple giant bilobar hepatic hydatid cysts. Careful patient selection, strict anti-spillage precautions, perioperative albendazole, meticulous surgical technique, and structured follow-up are essential for good outcomes.