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Percutaneous treatment of univesicular versus multivesicular hepatic hydatid cysts

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Abstract

Background

Percutaneous drainage has been used successfully to treat hepatic hydatid cysts. This study aimed to analyze the results of this method in the treatment of univesicular and multivesicular hepatic hydatid cysts.

Methods

Ultrasound-guided percutaneous drainage was used to treat 72 patients (44 women and 28 men; average age, 46.8 ± 17.7 years) with hepatic hydatidosis. Of these 72 patients, 57 had one cyst, 7 had two cysts, and 8 had three cysts. Albendazole (10 mg per kg of body weight daily for 8 weeks) was administered to all the patients. Serial assessments included clinical and biochemical examinations, ultrasonography, and serologic tests for echinococcal antibody titers.

Results

During the follow-up period, the mean cyst diameter decreased from 83.3 ± 38.6 mm to 11.1 ± 16.0 mm (p < 0.001) in the multivesicular group (27 cysts) and from 65.5 ± 27.5 to 5.9 ± 13.0 mm (p < 0.001) in the univesicular group (68 cysts). The final cyst diameter did not differ significantly between the two groups (p = 0.1). The findings showed that 81% of the cysts in the univesicular group and 63% in the multivesicular group disappeared (p = 0.12). The mean hospital stay was 4.8 ± 2.9 days in the univesicular group and 6.1 ± 4.7 days in the multivesicular group (p < 0.001). After an initial rise, the echinococcal-antibody titers fell progressively, and at the last follow-up evaluation were negative (<1:160) for 43 patients (94%) in the univesicular group and 19 patients (73%) in the multivesicular group (p = 0.03). Mild nonfatal complications were experienced by 24 patients (33%).

Conclusions

Percutaneous drainage combined with albendazole therapy is an effective and safe method for managing hydatid cysts of the liver that requires a short hospital stay. Disappearance of the cysts depends on cyst size. Multivesicular cysts have a more complicated course, a slower disappearance, and a higher incidence of positive echinococcal-antibody titers. Abscess formed after the procedure can be treated successfully by percutaneous drainage.

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References

  1. Coyle CM, Wittner M (1999) Parasitic diseases of the liver. In: Lawrence JB (eds). Clinical practice of gastroenterology, Churchill Livingstone, Philadelphia pp 908–921

    Google Scholar 

  2. Milicevic M (1994) Hydatid disease. In: Blumgart LH (eds). Surgery of the liver and biliary tract. 2nd ed. Churchill Livingstone, Edinburgh pp 1121–1150

    Google Scholar 

  3. Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20: 795–781

    PubMed  CAS  Google Scholar 

  4. Brunetti E, Maiocchi L, Garlaschelli AL, Gulizia R, Filice C (2004) Overview of therapeutic options for cystic echinococcosis. Parassitologia 46: 53–55

    PubMed  CAS  Google Scholar 

  5. Schipper HG, Kagar PA (2004) Diagnosis and treatment of hepatic echinococcosis: an overview. Scand J Gastroenterol 241(Suppl 1): 50–55

    Article  Google Scholar 

  6. Alfieri S, Doglietto GB, Pacelli F, Costamagna G, Carriero C, Mutignani M, Liberatori (1997) Radical surgery for liver hydatid disease: a study of 89 consecutive patients. Hepatogastroenterology 44: 496–500

    PubMed  CAS  Google Scholar 

  7. Wagholikar GD, Sikora SS, Kumar A, Saxena R, Kapoor VK (2002) Surgical management of complicated hydatid cysts of the liver. Trop Gastroenterol 23: 35–37

    PubMed  CAS  Google Scholar 

  8. Chautems R, Buhler L, Gold B, Chilcott M, Morel P, Mentha G (2003) Long-term results after complete or incomplete surgical resection of liver hydatid disease. Swiss Med Wkly 133: 258–262

    PubMed  Google Scholar 

  9. Manterola C, Espinoza R, Munoz S, Vial M, Bustos L, Losada H, Barroso M (2004) Abdominal echinococcosis during pregnancy: clinical aspects and management of a series of cases in Chile. Trop Doct 34: 171–173

    PubMed  Google Scholar 

  10. Seven R, Berber E, Mercan S, Eminoglu L, Budak D (2000) Laparoscopic treatment of hepatic hydatid cysts. Surgery 128: 36–40

    Article  PubMed  CAS  Google Scholar 

  11. Sgourakis G, Gemos K, Dedemadi G, Spetzouris N, Gyftakis H, Salapa P (2001) Laparoscopic drainage of infected hydatid liver cysts. Minerva Chir 56: 169–173

    PubMed  CAS  Google Scholar 

  12. Bickel A, Loberant N, Singer-Jordan J, Goldfeld M, Daud G, Eitan A (2001) The laparoscopic approach to abdominal hydatid cysts: a prospective nonselective study using the isolated hypobaric technique. Arch Surg 136: 789–795

    Article  PubMed  CAS  Google Scholar 

  13. Verma GR, Bose SM (1998) Laparoscopic treatment of hepatic hydatid cyst. Surg Laparosc Endosc 8: 280–282

    Article  PubMed  CAS  Google Scholar 

  14. Teggi A, Lastilla MG, De Rosa F (1993) Therapy of human hydatid disease with mebendazole and albendasole. Antimicrob Agents Chemother 37: 1679–1684

    PubMed  CAS  Google Scholar 

  15. Horton RJ (1997) Albendazole in treatment of human echinococcosis:12 years of experience. Acta Tropica 64: 79–93

    Article  PubMed  CAS  Google Scholar 

  16. Khuroo MS, Dar MY, Yattoo GN, Zarger SA, Javid G, Khan BA, Boda MI (1993) Percutaneous drainage versus albendasole therapy in hepatic hydatidosis: a prospective randomized study. Gastroenterology 104: 1452–1459

    PubMed  CAS  Google Scholar 

  17. Crippa FG, Bruno R, Brunetti E, Filice C (1999) Echinococcal liver cysts treatment with echo-guided percutaneous puncture PAIR. Ital J Gastroenterol Hepatol 31: 884–892

    PubMed  CAS  Google Scholar 

  18. Akhan O, Ozmen MN (1999) Percutaneous treatment of liver hydatid cysts. Eur J Radiol 32: 76–85

    Article  PubMed  CAS  Google Scholar 

  19. Men S, Hekimoglu B, Yucesoy C, Arda IS, Baran I (1999) Percutaneous treatment of hepatic hydatid cysts: an alternative to surgery. AJR Am J Roentgenol 172: 83–89

    PubMed  CAS  Google Scholar 

  20. Etlik O, Arslan H, Bay A, Sakarya ME, Harman M, Temizoz O, et al (2004) Abdominal hydatid disease: long-term results of percutaneous treatment. Acta Radiol 45: 383–389

    Article  PubMed  CAS  Google Scholar 

  21. Gori S, Campatelli A, Luchi S, Paladini A, Savalli E, Scasso A (1993) Cytology in the percutaneous treatment of hydatid cysts: a report of four cases. Acta Cytol 37: 423–426

    PubMed  CAS  Google Scholar 

  22. Munro BH, Visintainer MA, Page EB (1986) Statistical methods for health care workers. JB Lippincott, Philadelphia

    Google Scholar 

  23. WHO Informal Working Group on Echinoccosis (1996) Guidelines for treatment of cystic and alveolar echinococcosis in humans. Bull World Health Organ 74: 231–242

    Google Scholar 

  24. Lewall DB, Mc Crokell SJ (1986) Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol 146: 391–394

    PubMed  CAS  Google Scholar 

  25. Filice C, Brunetti E (1997) Use of PAIR in human cystic echinococcosis. Acta Trop 64: 95–107

    Article  PubMed  CAS  Google Scholar 

  26. Smego RA, Jr, Sebanego P (2005) Treatment options for hepatic cystic echinococcosis. Int J Infect Dis 9: 69–76

    Article  PubMed  Google Scholar 

  27. Akhan O, Ozmen MN, Dincer A, Sayek IS, Gocman A (1996) Liver hydatid disease: long-term results of percutaneous treatment. Radiology 198: 259–264

    PubMed  CAS  Google Scholar 

  28. Ustunsoz B, Akhan O, Kamiloglu MA, Somuncu I, Ugurel MS, Cetiner S (1999) Percutaneous treatment of hydatid cysts of the liver: long-term results. AJR Am J Roentgenol 172: 91–96

    PubMed  CAS  Google Scholar 

  29. Khuroo MS, Wani NA, Javid G, Khan BA, Yattoo GN, Shah AH, Jeelani SG (1997) Percutaneous drainage compared with surgery for hepatic hydatid cysts. New Eng J Med 337: 881–887

    Article  PubMed  CAS  Google Scholar 

  30. Schipper H, Kager PA (1997) Percutaneous drainage of hydatid cysts (letter). New Eng J Med 338: 391–392

    Article  Google Scholar 

  31. Jabbour N, Shirazi SK, Genyk Y, Mateo R, Pak E, Cosenza DC, Genyk YS, Mateo R (2002) Surgical management of complicated hydatid disease of the liver. Am Surg 68: 984–988

    PubMed  Google Scholar 

  32. Manterola C, Barroso M, Vial M, Bustos L, Munoz S, Losada H, Bello N, Hernandez F, Carasco R (2003) Liver abscess of hydatid origin: clinical features and results of aggressive treatment. ANZ J Surg 73: 220–224

    Article  PubMed  Google Scholar 

  33. Tan A, Yakut M, Kaymakcioglu N, Ozerhan IH, Cetiner S, Akendiz A (1998) The results of surgical treatment and percutaneous drainage of hepatic hydatid disease. Int Surg 83: 314–316

    PubMed  CAS  Google Scholar 

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  1. The Interventional Ultrasonography Department, University Clinical Center, Tuzla, Bosnia and Herzegovina

    E. Zerem & R. Jusufovic

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  1. E. Zerem
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  2. R. Jusufovic
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Zerem, E., Jusufovic, R. Percutaneous treatment of univesicular versus multivesicular hepatic hydatid cysts. Surg Endosc 20, 1543–1547 (2006). https://doi.org/10.1007/s00464-006-0135-z

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