Total Pericystectomy in Liver Echynococcal Cysts Using Bipolar Sealing Coupled with Saline Device

In multiple and complicated liver echinococcal cysts, management is challenging and requires a combination of preoperative chemotherapy and surgical intervention. The optimal operative method in echinococcal cyst management is yet to be agreed [1,2], however it has been shown that radical procedures, including total pericystectomy, appear with fewer relapses and, the past years, there has been a shift towards the more aggressive surgical approach, due to the decreased postoperative complications and lower mortality when related to conservative techniques [3,4,5]. The main goal when treating echinococcal cysts is to prepare the patient properly, both preoperatively, by providing the right chemotherapeutic agent, and perform a safe surgical procedure, by avoiding rupture and spillage of the cyst, performing a virtually bloodless operation and keeping mortality and morbidity to minimum.