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Echinococcus granulosus infection: the challenge of surgical treatment

  • Current Concepts in Clinical Surgery
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Abstract

Background

Cystic echinococcosis (CE) is a worldwide zoonosis caused by larval stages of the cestode Echinococcus granulosus. Surgery, chemotherapy, and interventional procedures are the therapeutic options. Surgery can cure the patient if the parasite is removed entirely. However, the technical procedures are inconsistent and comprise partial liver resection or opening of the parasitic cyst and removal of the parasite. Laparotomy is the most common approach. In selected cases laparoscopic methods are successful. Retrospective studies outweigh prospective ones by far. However, proper management gives favorable results.

Methods

We critically review the literature and present a brief summary of current surgical strategy and focus on issues relevant for surgeons: diagnosis, indication for medical treatment, indication for surgical treatment, surgical procedures, scolicidal agents, morbidity, mortality, recurrence, perioperative medication, standards.

Results

All surgical procedures aim at the complete removal of the parasite. Liver resection and pericystectomy are procedures that resect the closed cysts with a fairly wide safety margin. A meta-analysis shows the best results regarding lethality (1.2%), morbidity (11.7%), and recurrence rates (2%) for resective operations. However, most surgeons consider these methods as too radical for a benign disease. Procedures that remove the parasite and keep the pericyst (=cystectomy) are easier to carry out than resective ones. The meta-analysis presented revealed a lethality of 2%, morbidity of 23%, and recurrence rate of 10.4% for these operations. Omentoplasty is the option of choice for the management of the remaining cyst cavity. Despite alternative procedures surgery is the treatment of choice. Supportive measures comprise the use of scolicidal agents and postoperative benzimidazole administration. However, a critical review of the literature disclosed a lack of scientific confirmation of established treatment modalities and procedures. The results of ultrasound imaging were classified and correlated to the developmental phases of CE.

Conclusions

Cystectomy and omentoplasty for CE should be the standard surgical procedure because it is safe, simple, and effective and meets all criteria of surgical treatment for hydatid disease: entire elimination of the parasite, no intraoperative spillage especially by using a cone, and saving healthy tissue. Pericystectomy should be used for peripherally located liver cysts that are surrounded by parenchyma only partially. Ultrasonic classification of the parasitic lesion should be used as a guideline for therapeutic measures.

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References

  1. Ammann RW, Eckert J (1996) Cestodes; Echinococcus. Gastroenterol Clin North Am 25:655–689

    CAS  PubMed  Google Scholar 

  2. Lethbridge RC (1980) The biology of the oncosphere of cyclophyllidean cestodes. Helminthol Abstr A49:59–72

    Google Scholar 

  3. Schantz PM, Chai J, Craig PS, Eckert J, Jenkins DJ, Macpherson CNL, Thakur A (1995) Epidemiology and control of hydatid disease. In: Thompson RCA, Lymbery AJ (eds) Echinococcus and hydatid disease. CAB International, Wallingford, pp 233–331

  4. Thompson RCA, Lymbery AJ, Constantine CC (1995) Variation in echinococcus: towards a taxonomic revision of the genus. Adv Parasitol 35:145–176

    CAS  PubMed  Google Scholar 

  5. Ammann R, Eckert J (1995) Clinical diagnosis and treatment of echinococcosis in humans. In: Thompson RCA, Lymbery AJ (eds) Echinococcus and hydatid disease. CAB International, Wallingford, pp 411–463

  6. Kehila M, Ammar N, Hattab C, Letaief R, Khabthani H, Hamida RB, Khalfallah A, Said R, Jerbi A, Gharbi S (1988) Etude statistique des localisations hydatiques. A propos de 644 cas, 1980–1986. Tunis Med 66:587–591

    CAS  PubMed  Google Scholar 

  7. Wilson JF, Diddams AC, Rausch RL (1968) Cystic hydatid disease in Alaska. A review of 101 autochthonous cases of Echinococcus granulosus infection. Am Rev Respir Dis 98:1–15

    CAS  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  9. RomigT (1990) Beobachtungen zur zystischen Echinokokkose des Menschen im Turkana-Gebiet, Kenia. Thesis, University of Hohenheim

  10. Milicevic M (2000) Hydatid disease. In: Blumgart LH, Fong Y (eds) Surgery of the liver and biliary tract. Saunders, Philadelphia, pp 1167–1204

  11. Craig PS, Rogan MT, Allan JC (1996) Detection, screening and community epidemiology of taeniid cestode zoonoses: cystic echinococcosis, alveolar echinococcosis and neurocysticercosis. In: Baker JR, Muller R, Rollinson D (eds) Advances in parasitology. Academic, San Diego, pp 169–250

  12. Pawlowski ZS (1993) Critical points in the clinical management of cystic echinococcosis. In: Andersen FL, Chai J, Liu F (eds) Compendium on cystic echinococcosis with special reference to Xinjiang Uygur Autonomous Region of the People's Republic of China. Brigham Young University, Provo, pp 119–134

  13. Placer C, Martin R, Sanchez E, Soleto E (1988) Rupture of abdominal hydatid cysts. Br J Surg 75:157

    CAS  PubMed  Google Scholar 

  14. Gharbi HA, Hassine B, Brauner MW, Dupuch K (1981) Ultrasound examination of hydatic liver. Radiology 139:459–463

    CAS  PubMed  Google Scholar 

  15. Niron EA, Ozer H (1981) Ultrasound appearances of liver hydatid disease. Br J Radiol 54:335–338

    CAS  PubMed  Google Scholar 

  16. WHO/OIE (2001) Manual on echinococcosis in humans and animals: a public health problem of global concern. World Organisation for Animal Health and World Health Organisation, Paris, France

    Google Scholar 

  17. Perdomo R, Alvarez C, Monti J, Ferreira C, Chiesa A, Carbo A, Alvez R, Grauert R, Stern D, Carmona C, Yarzabal L (1997) Principles of the surgical approach in human liver cystic echinococcosis. Acta Trop 64:109–122

    Article  CAS  PubMed  Google Scholar 

  18. Caremani M, Benci A, Maestrini R, Accorsi A, Caremani D, Lapini L (1997) Ultrasound imaging in cystic echinococcosis. Proposal of a new sonographic classification. Acta Trop 67:91–105

    Article  CAS  PubMed  Google Scholar 

  19. Vuitton DA (1997) The WHO Informal Working Group on Echinococcosis. The Coordinating Board of the WHO-IWGE. Acta Trop 67:147–148

    Article  CAS  PubMed  Google Scholar 

  20. Sayek I, Onat D (2001) Diagnosis and treatment of uncomplicated hydatid cyst of the liver. World J Surg 25:21–27

    Article  CAS  PubMed  Google Scholar 

  21. Pawlowski ZS, Eckert J, Vuitton D, Ammann RW, Kern P, Craig PS, Dar FK, De Rosa F, Filice C, Gottstein B, Grimm F, Macpherson CNL, Sato N, Todorov T, Uchino J, von Sinner W, Wen H (2001) Echinococcosis in humans: clinical aspects, diagnosis and treatment. In: Eckert J, Gemmell MA, Meslin FX, Pawlowski Z (eds) WHO/OIE Manual on echinococcosis in humans and animals: a public health problem of global concern. World Organisation for Animal Health and World Health Organisation, Paris, France, pp 20–71

  22. Morris DL, Richards KS (1992) Hydatid disease. Butterworth-Heinemann, Oxford

  23. Duewell S, Marincek B, von Schulthess GK, Ammann R (1990) MRT and CT in alveolar echinococcosis of the liver. Fortschr Roentgenstr 152:441–445

    CAS  Google Scholar 

  24. Reuter S, Nussle K, Kolokythas O, Haug U, Rieber A, Kern P, Kratzer W (2001) Alveolar liver echinococcosis: a comparative study of three imaging techniques. Infection 29:119–125

    Article  CAS  PubMed  Google Scholar 

  25. Sbihi Y, Rmiqui A, Rodriguez-Cabezas MN, Orduna A, Rodriguez-Torres A, Osuna A (2001) Comparative sensitivity of six serological tests and diagnostic value of ELISA using purified antigen in hydatidosis. J Clin Lab Anal 15:14–18

    Article  CAS  PubMed  Google Scholar 

  26. Menghebat L, Jiang L, Chai J, National Hydatid Disease Center of China (1993) A retrospective survey for surgical cases of cystic echinococcosis in the Xinjiang Uygur Autonomous Region, PRC (1951–90). In: Andersen FL (ed) Compendium of cystic echinococcosis with special reference to the Xinjiang Uygur Autonomous Region of the the Peoples Republic of China. Brigham Young University, Provo, pp 135–145

  27. Balik AA, Basoglu M, Celebi F, Oren D, Polat KY, Atamanalp SS, Akcay MN (1999) Surgical treatment of hydatid disease of the liver: review of 304 cases. Arch Surg 134:166–169

    PubMed  Google Scholar 

  28. 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  CAS  PubMed  Google Scholar 

  29. Saimot AG (2001) Medical treatment of liver hydatidosis. World J Surg 25:15–20

    Article  CAS  PubMed  Google Scholar 

  30. Ammann RW, Hirsbrunner R, Cotting J, Steiger U, Jacquier P, Eckert J (1990) Recurrence rate after discontinuation of long-term mebendazole therapy in alveolar echinococcosis (preliminary results). Am J Trop Med Hyg 43:506–515

    CAS  PubMed  Google Scholar 

  31. Ammann RW, Fleiner HA, Grimm F, Eckert J (1998) Long-term mebendazole therapy may be parasitocidal in alveolar echinococcosis. J Hepatol 29:994–998

    Article  CAS  PubMed  Google Scholar 

  32. Wilson JF, Rausch RL, McMahon BJ, Schantz PM (1992) Parasiticidal effect of chemotherapy in alveolar hydatid disease. Review of experience with mebendazole and albendazole in Alascan Eskimos. Clin Infect Dis 15:234–249

    CAS  PubMed  Google Scholar 

  33. Ammann RW, Hoffmann AF, Eckert J (1999) Schweizerische Studie für Chemotherapie der alveolären Echinokokkose-Rückblick auf ein 20-jähriges klinisches Forschungsprojekt. Schweiz Med Wochenschr 129:323–332

    CAS  PubMed  Google Scholar 

  34. Cobo F, Yarnoz C, Sesma B, Fraile P, Aizcorbe M, Trujillo R, Diaz-de-Liano A, Ciga MA (1998) Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatisosis caused by Echinococcus granulosus. Trop Med Int Health 3:462–466

    Article  CAS  PubMed  Google Scholar 

  35. Blanton RE, Wachira TM, Zeyhle EE, Njoroge EM, Magambo JK, Schantz PM (1998) Oxfendazole treatment for cystic hydatid disease in naturally infected animals. Antimicrob Agents Chemother 42:601–605

    CAS  PubMed  Google Scholar 

  36. Saidi F (1976) Surgery of hydatid disease. Saunders, Philadelphia

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

    CAS  PubMed  Google Scholar 

  38. Haddad MC, Huwaijah SH, Mourad FH, Sharara AI, Al Kutoubi AO (2000) Adjuvant therapy in the treatment of complications following surgery for hepatic echinococcal cysts. Cardiovasc Intervent Radiol 23:406–409

    Article  CAS  PubMed  Google Scholar 

  39. Saglam A (1996) Laparoscopic treatment of liver hydatid cysts. Surg Laparosc Endosc 6:16–21

    Article  CAS  PubMed  Google Scholar 

  40. Besim H, Karayalcin K, Hamamci O, Gungor C, Korkmaz A (1998) Scolicidal agents in hydatid cyst surgery. HPB Surg 10:347–351

    CAS  PubMed  Google Scholar 

  41. Sayek I, Yalin R, Sanac Y (1980) Surgical treatment of hydatid disease of the liver. Arch Surg 115:847–850

    CAS  PubMed  Google Scholar 

  42. Ayles HM, Corbett EL, Taylor I, Cowie A-GA, Bligh J, Walmsley K, Bryceson A-DM (2002) A combined medical and surgical approach to hydatid disease: 12 years' experience at the Hospital for Tropical Diseases, London. Ann R Coll Surg Engl 84:100–105

    CAS  PubMed  Google Scholar 

  43. Utkan NZ, Canturk NZ, Gonullu N, Yildirir C, Dulger M (2001) Surgical experience of hydatid disease of the liver: omentoplasty or capitonnage versus tube drainage. Hepatogastroenterology 48:203–207

    CAS  PubMed  Google Scholar 

  44. Cirenei A, Bertoldi I (2001) Evolution of surgery for liver hydatidosis from 1950 to today: analysis of a personal experience. World J Surg 25:87–92

    Article  CAS  PubMed  Google Scholar 

  45. Magistrelli P, Masetti R, Coppola R, Messia A, Nuzzo G, Picciocchi A (1991) Surgical treatment of hydatid disease of the liver. A 20-year experience. Arch Surg 126:518–522

    CAS  PubMed  Google Scholar 

  46. Mentes A (1994) Hydatid liver disease: a perspective in treatment. Dig Dis 12:150–160

    CAS  PubMed  Google Scholar 

  47. Langer JC, Rose DB, Keystone JS, Taylor BR, Langer B (1984) Diagnosis and management of hydatid disease of the liver. A 15-year North American experience. Ann Surg 199:412–417

    CAS  PubMed  Google Scholar 

  48. Mentes A, Yuezer Y, Ozbal O, Coker A, Ilter T, Musoglu A (1993) Omentoplasty versus introflexion for hydatid liver cysts. J R Coll Surg Edinb 38:82–85

    CAS  PubMed  Google Scholar 

  49. Cangiotti L, Giulini SM, Muiesan P, Nodari F, Begni A, Tiberio G (1991) Hydatid disease of the liver: long term results of surgical treatment. G Chir 12:501–504

    CAS  PubMed  Google Scholar 

  50. Ariogul O, Emre A, Alper A, Uras A (1989) Introflexion as a method of surgical treatment for hydatid disease. Surg Gynecol Obstet: 356–358

    Google Scholar 

  51. Moreno Gonzalez E, Rico Selas P, Martinez B, Garcia Garcia I, Palma Carazo F, Hidalgo Pascual M (1991) Results of surgical treatment of hepatic hydatidosis: current therapeutic modifications. World J Surg 15:254–263

    PubMed  Google Scholar 

  52. Yol S, Kartal A, Tavli S, Sahin M, Vatansev C, Karahan O, Belviranli M (1999) Open drainage versus overlapping method in the treatment of hepatic hydatid cyst cavities. Int Surg 84:139–143

    CAS  PubMed  Google Scholar 

  53. Ekrami Y (1976) Surgical treatment of hydatid disease of the liver. Arch Surg 111:1350–1352

    CAS  PubMed  Google Scholar 

  54. Kunz R, Kunath U, Lackner K (1983) Komplikationen und Spätergebnisse nach chirurgischer Behandlung des Echinococus granulosus. Chirurg 54:283–287

    CAS  PubMed  Google Scholar 

  55. Papadimitriou J, Mandrekas A (1970) The surgical treatment of hydatid disease of the liver. Br J Surg 57:431–433

    CAS  PubMed  Google Scholar 

  56. Ozmen V, Igci A, Kebudi A, Kecer M, Bozfakioglu Y, Parlak M (1992) Surgical treatment of hepatic hydatid disease. Can J Surg 35:423–427

    CAS  PubMed  Google Scholar 

  57. Aktan AO, Yalin R, Yegen C, Okboy N (1993) Surgical treatment of hepatic hydatid cysts. Acta Chir Belg 93:151–153

    CAS  PubMed  Google Scholar 

  58. Xynos E, Pechlivanides G, Tzortzinis A, Papageorgiou A, Vassilakis JS (1993) Hydatid disease of the liver. Diagnosis and surgical treatment. HPB Surg 4:59–66

    Google Scholar 

  59. Safioleas M, Misiakos E, Manti C, Katsikas D, Skalkeas G (1994) Diagnostic evaluation and surgical management of hydatid disease of the liver. World J Surg 18:859–865

    CAS  PubMed  Google Scholar 

  60. Akinoglu A, Bilgin I, Erkocak EU (1985) Surgical management of hydatid disease of the liver. Can J Surg 28:171–2:174

    Google Scholar 

  61. Herfarth C, Friedl P (1982) Chirurgische Therapie des Echinococcus granulosus der Leber. In: Bähr R (ed) Probleme der Echinokokkose unter Berücksichtigung parasitologischer und klinischer Aspekte. Huber, Bern, pp 110–118

  62. Ozacmak ID, Ekiz F, Ozmen V, Isik A (2000) Management of residual cavity after partial cystectomy for hepatic hydatidosis: comparison of omentoplasty with external drainage. Eur J Surg 166:696–699

    Article  CAS  PubMed  Google Scholar 

  63. Dziri C, Paquet JC, Hay JM, Fingerhut A, Msika S, Zeitoun G, Sastre B, Khalfallah T (1999) Omentoplasty in the prevention of deep abdominal complications after surgery for hydatid disease of the liver: a multicenter, prospective, randomized trial. French Associations for Surgical Research. J Am Coll Surg 188:281–289

    Article  CAS  PubMed  Google Scholar 

  64. Aarons BJ, Kune GA (1983) A suction cone to prevent spillage during hydatid surgery. Aust N Z J Surg 53:471–472

    CAS  PubMed  Google Scholar 

  65. Saidi F, Nazarian I (1971) Surgical treatment of hydatid cysts by freezing of cyst wall and installation of 0.5 per cent silver nitrate solution. N Engl J Med 284:1346–1350

    CAS  PubMed  Google Scholar 

  66. Buttenschoen K, Kunz R, Kern P, Strecker W, Beger HG (1999) Zystische Echinokokkose in der Dritten Welt und neue Entwicklungen—Cystic echinococcosis in Third-World countries and new developments. In: Strecker W, Kinzl L (eds) Tropenchirurgie III/Tropical surgery III. Springer, Berlin Heidelberg New York, pp 416–438

  67. Aktan AO, Yalin R (1996) Preoperative albendazole treatment for liver hydatid disease decreases the viability of the cyst. Eur J Gastroenterol Hepatol 8:877–879

    CAS  PubMed  Google Scholar 

  68. Tsimoyiannis EC, Siakas P, Glantzounis G, Tsimoyiannis JC, Karayianni M, Gossios KJ (2000) Intracystic pressure and viability in hydatid disease of the liver. Int Surg 85:234–236

    CAS  PubMed  Google Scholar 

  69. Yorganci K, Sayek I (2002) Surgical treatment of hydatid cysts of the liver in the era of percutaneous treatment. Am J Surg 184:63–69

    Article  PubMed  Google Scholar 

  70. Gruttadauria S, Arino G, Gruttadauria G (1996) Development of echinococcosis diagnosis and treatment over a 20-year period. European IHPB Congress. International proceeding. Monduzzi, Bologna, pp 207–210

  71. Morel P, Robert J, Rohner A (1988) Surgical treatment of hydatid disease of the liver: a survey of 69 patients. Surgery 104:859–862

    CAS  PubMed  Google Scholar 

  72. Pitt HA, Korzelius J, Tompkins RK (1986) Management of hepatic echinococcosis in southern California. Am J Surg 152:110–115

    CAS  PubMed  Google Scholar 

  73. Uravic M, Stimac D, Lenac T, Ivanis N, Petrosic N, Rubinic M, Skarpa A (1998) Diagnosis and treatment of liver hydatid disease. Hepatogastroenterology 45:2265–2269

    CAS  PubMed  Google Scholar 

  74. Demirci S, Eraslan S, Anadol E, Bozatli L (1989) Comparison of the results of different surgical techniques in the management of hydatid cysts of the liver. World J Surg 13:88–91

    CAS  PubMed  Google Scholar 

  75. Göksoy E, Düren M (2000) Operative Therapie des Echinococcus granulosus (cysticus). Chirurg 71:21–29

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  77. Katkhouda N, Fabiani P, Benizri E, Mouiel J (1992) Laser resection of a liver hydatid cyst under videolaparoscopy. Br J Surg 79:560–561

    CAS  PubMed  Google Scholar 

  78. Alper A, Emre A, Hazar H, Ozden I, Bilge O, Acarli K, Ariogul O (1995) Laparoscopic surgery of hepatic hydatid disease: initial results and early follow-up of 16 patients. World J Surg 19:725–728

    CAS  PubMed  Google Scholar 

  79. Yücel O, Talu M, Ünalmiser S, Özdede S, Gürkan A (1996) Videolaparoscopic treatment of liver hydatid cysts with partial cystectomy and omentoplasty. A report of two cases. Surg Endosc 10:434–436

    Article  PubMed  Google Scholar 

  80. Bickel A, Eitan A (1995) The use of a large, transparent cannula, with a beveled tip, for safe laparoscopic management of hydatid cysts of liver. Surg Endosc 9:1304–1305

    CAS  PubMed  Google Scholar 

  81. Rogiers X, Bloechle C, Broelsch CE (1995) Safe decompression of hepatic hydatid cyst with a laparoscopic surgiport. Br J Surg 82:1111

    CAS  PubMed  Google Scholar 

  82. Gökce O, Gökce C, Yilmaz M, Hüseyinoglu K, Günel S (1991) Povidone-iodine in experimental peritoneal hydatidosis. Br J Surg 78:495–496

    PubMed  Google Scholar 

  83. Sonisik M, Korkmaz A, Besim H, Karayalcin K, Hamamci O (1998) Efficacy of cetrimide-chlorhexidine combination in surgery for hydatid cyst. Br J Surg 85:1277

    Article  CAS  PubMed  Google Scholar 

  84. Belghiti J, Benhamou JP, Houry S, Grenier P, Huguier M, Fekete F (1986) Caustic sclerosing cholangitis. A complication of the surgical treatment of hydatid disease of the liver. Arch Surg 121:1162–1165

    CAS  PubMed  Google Scholar 

  85. Prasad J, Bellamy PR, Stubbs RS (1991) Instillation of scolicidal agents into hepatic hydatid cysts: can it any longer be justified? N Z Med J 104:336–337

    Google Scholar 

  86. Baraka A, Wakid N, Yamout F (1980) Methemoglobinemia during surgical excision of hydatid cyst. Middle East J Anaesthesiol 5:509–513

    CAS  PubMed  Google Scholar 

  87. Cakmakci M, Sayek I (1992) Prophylactic effect of albendazole in experimental peritoneal hydatidosis. Hepatogastroenterology 39:424–426

    CAS  PubMed  Google Scholar 

  88. Khodadadi DJ, Kurgan A, Schmidt B (1981) Sclerosing cholangitis following the treatment of echinococcosis of the liver. Int Surg 66:361–362

    CAS  PubMed  Google Scholar 

  89. Castellano G, Moreno-Sanchez D, Gutierrez J, Moreno-Gonzalez E, Colina F, Solis-Herruzo JA (1994) Caustic sclerosing cholangitis. Report of four cases and a cumulative review of the literature. Hepatogastroenterology 41:458–470

    CAS  PubMed  Google Scholar 

  90. Haddad CG, Agrawal N, Litwin MS (1983) Diagnosis and treatment of echinococcal cy of the liver. South Med J 76:300–303

    CAS  PubMed  Google Scholar 

  91. Aggarwal AR, Garg RL (1983) Formalin toxicity in hydatid liver disease. Anaesthesia 38:662–665

    CAS  PubMed  Google Scholar 

  92. Gilchrist DS (1979) Chemical peritonitis after cetrimide washout in hydatid-cyst surgery. Lancet II:1374

    Google Scholar 

  93. Baraka A, Yamut F, Wakid N (1980) Cetrimide-induced methaemoglobinaemia after surgical excision of hydatid cyst. Lancet II:88–89

    Google Scholar 

  94. Momblano P, Pradere B, Jarrige N, Concina D, Bloom E (1984) Metabolic acidosis induced by cetrimonium bromide. Lancet II:1045

    Google Scholar 

  95. Turkcapar AG, Ersoz S, Gungor C, Aydinuraz K, Yerdel MA, Aras N (1997) Surgical treatment of hepatic hydatidosis combined with perioperative treatment with albendazole. Eur J Surg 163:923–928

    CAS  PubMed  Google Scholar 

  96. Sayek I, Cakmakci M (1986) The effect of prophylactic mebendazole in experimental peritoneal hydatidosis. Surg Gynecol Obstet 163:351–353

    CAS  PubMed  Google Scholar 

  97. Morris DL (1987) Pre-operative albendazole therapy for hydatid cyst. Br J Surg 74:805–806

    CAS  PubMed  Google Scholar 

  98. Davidson RN, Bryceson AD, Cowie AG, McManus DP (1988) Pre-operative albendazole therapy and hydatid cysts. Br J Surg 75:398

    CAS  PubMed  Google Scholar 

  99. Gil Grande LA, Rodriguez Caabeiro F, Prieto JG, Sanchez Ruano JJ, Brasa C, Aguilar L, Garcia Hoz F, Casado N, Barcena R, Alvarez AI, et al (1993) Randomised controlled trial of efficacy of albendazole in intra-abdominal hydatid disease. Lancet 342:1269–1272

    CAS  PubMed  Google Scholar 

  100. Morris DL, Chinnery JB, Hardcastle JD (1986) Can albendazole reduce the risk of implantation of spilled protoscoleces? An animal study. Trans R Soc Trop Med Hyg 80:481–484

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  102. Pelaez V, Kugler C, Correa D, Del Carpio M, Guangiroli M, Molina J, Marcos B, Lopez E (2000) PAIR as percutaneous treatment of hydatid liver cysts. Acta Trop 75:197–202

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  104. Örmeci N, Soykan I, Bektas A, Sanoglu M, Palabiyikoglu M, Hadi-Yasa M, Dökmeci A, Uzunalimoglu Ö (2001) A new percutaneous approach for the treatment of hydatid cysts of the liver. Am J Gastroenterol 96:2225–2230

    Article  PubMed  Google Scholar 

  105. Schipper HG, Lameris JS, van Delden OM, Rauws EA, Kager PA (2002) Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method. Gut 50:718–723

    Article  CAS  PubMed  Google Scholar 

  106. Röthlin M, Decurtins M, Largiader F (1994) Resultate der Chirurgie bei Leberechinokokkose [Results of surgery in hepatic echinococcosis]. Helv Chir Acta 60:587–592

    PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  108. Haddad MC, Al Awar G, Huwaijah SH, Al Kutoubi AO (2001) Echinococcal cysts of the liver: a retrospective analysis of clinico-radiological findings and different therapeutic modalities. Clin Imaging 25:403–408

    Article  CAS  PubMed  Google Scholar 

  109. Di Matteo G, Bove A, Chiarini S, Capuano LG, De Antoni E, Lanzi G, Lippolis G, Campana FP (1996) Hepatic echinococcus disease: our experience over 22 years. Hepatogastroenterology 43:1562–1565

    PubMed  Google Scholar 

  110. Xu M (1995) Progress in surgical treatment of hydatid diseases in China. A clinical analysis of 22:005 surgical cases. Chin Med J (Engl) 108:295–299

    Google Scholar 

  111. Vagianos CE, Karavias DD, Kakkos SK, Vagenas CA, Androulakis JA (1995) Conservative surgery in the treatment of hepatic hydatidosis. Eur J Surg 161:415–420

    CAS  PubMed  Google Scholar 

  112. Karavias DD, Vagianos CE, Bouboulis N, Rathosis S, Androulakis J (1992) Improved techniques in the surgical treatment of hepatic hydatidosis. Surg Gynecol Obstet 174:176–180

    CAS  PubMed  Google Scholar 

  113. Manterola C, Fernandez O, Munoz S, Vial M, Losada H, Carrasco R, Bello N, Barroso M (2002) Laparoscopic pericystectomy for liver hydatid cysts. Surg Endosc 16:521–524

    Article  CAS  PubMed  Google Scholar 

  114. Khoury G, Jabbour-Khoury S, Bikhazi K (1996) Results of laparoscopic treatment of hydatid cysts of the liver. Surg Endosc 10:57–59

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Ulm, Steinhoevelstrasse 9, 89075, Ulm, Germany

    K. Buttenschoen

  2. Department of Anesthesiology, University of Ulm, Steinhoevelstrasse 9, 89075, Ulm, Germany

    D. Carli Buttenschoen

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  1. K. Buttenschoen
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  2. D. Carli Buttenschoen
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Correspondence to K. Buttenschoen.

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Buttenschoen, K., Carli Buttenschoen, D. Echinococcus granulosus infection: the challenge of surgical treatment. Langenbecks Arch Surg 388, 218–230 (2003). https://doi.org/10.1007/s00423-003-0397-z

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  • DOI: https://doi.org/10.1007/s00423-003-0397-z

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