Treatment Of Hepatic Hydatid Cysts Research Articles

Percutaneous treatment of hepatic hydatid cysts: an alternative to surgery.

Percutaneous treatment of hydatid cysts is relatively new, and the data related to it are limited. The purpose of this study was to provide additional data to strengthen the proof of its effectiveness. One hundred sixty-eight hepatic cysts in 111 patients were treated using a percutaneous approach under sonographic and fluoroscopic guidance. Cysts smaller than 5 cm in diameter were treated with a one-stage procedure that consisted of puncture of the cyst, aspiration of fluid, and injection and reaspiration of hypertonic saline solution. Larger cysts were treated with a two-stage procedure that consisted of the one-stage procedure followed by catheterization and sclerotherapy with alcohol. The mean observation time was 19 months (range, 1-48 months). Follow-up examinations showed progressive shrinkage and solidification of the cysts. Early complications occurred in 32 (28.8%) of the 111 patients, including fatal anaphylaxis in one patient, biliary fistula in seven, infection of the cyst in four, persistent serous drainage from the cyst in two, intraperitoneal leakage of cyst fluid in two, urticaria in seven, fever without evidence of infection in seven, and pleural effusion in two. Late complications occurred in four (3.8%) of the 104 patients who underwent follow-up examinations, including local recurrence in three patients and intrabiliary rupture of a cyst in one patient. Our experience indicates that percutaneous treatment is efficient in the management of hepatic hydatid cysts and that this technique should be considered an alternative to surgery.

Ultrasound-guided percutaneous drainage in the treatment of children with hepatic hydatid disease.

The present study was designed to establish the safety and efficacy of ultrasound-guided percutaneous drainage in the treatment of hepatic hydatid cysts in children. A total of 14 cysts in eight patients were drained under aseptic conditions and continuous ultrasound guidance. An 18-G needle was used for puncture and silver nitrate solution as the scolecoidal agent. All procedures were successful. During follow-up, repeated ultrasound examinations revealed a progressive decrease in cyst size and an alteration in the cyst echopattern. None of the patients had a rise in hydatid antibody titer. There were no immediate or late complications. We conclude that the safety and efficacy of ultrasound-guided percutaneous drainage are satisfactory for the treatment of hepatic hydatid cysts in children.

Diagnosis and treatment of hepatic hydatid cysts with the aid of echo-guided percutaneous cyst puncture.

The usefulness of echo-guided percutaneous cyst puncture in the diagnosis and treatment of hepatic hydatid cysts was assessed in a study of 45 patients referred to the Department of Tropical Medicine at Kasr El Aini Hospital in Cairo. All subjects had at least one hepatic cyst detected by ultrasonography (54 cysts in all), and 42 patients had positive results in serological tests for antibodies to Echinococcus granulosus. The majority of cysts were in the right hepatic lobe (40 cysts), were anechoic (51), and were rounded and smooth (49). All 45 active cysts (44 anechoic, rounded, and smooth; one anechoic and septated) yielded clear watery fluid containing scolices and exhibited elevated pressure on percutaneous puncture. In contrast, all nine inactive cysts yielded cloudy yellowish fluid without detectable scolices and did not display elevated pressure on puncture. The latter cysts were anechoic and elliptical (two cysts); anechoic and septated (one); anechoic with a calcified wall (one) or a detached germinal layer (two); or rounded with coarse echoes (three). Treatment by injection of a scolicidal agent (hypertonic saline) before withdrawal of the needle used for aspiration gave excellent results and was not associated with complications. Forty-three of the 45 patients had no clinical or ultrasonographic evidence of recurrent or new hepatic cysts after 3 years of follow-up.

Surgical Treatment of Hepatic Hydatid Cysts

This is a retrospective study of 44 surgical cases of hepatic hydatid cysts. The most common procedure was omentoplasty in 26 patients (55.3%), 10 with omentoplasty alone and 16 combined with partial

Conservative surgery for hydatid cysts of liver in children

Thirty patients below the age of 12 years were surgically treated for hydatid cysts of the liver. Twenty-two (73.3%) had a single cyst located in either hepatic lobe and eight (26.7%) harboured more than one cyst. Preoperative complications occurred in eight (26.7%) patients, which included jaundice in one, rupture in two and infection or bile staining in five. In one patient in the uncomplicated group of 22 (73.3%), left lateral hepatic segmentectomy was performed and in the rest, an endocyst was removed and an ectocyst was partially excised, with or without external tube drainage. No postoperative complications occurred in this group. However, three out of eight children with preoperative complications developed bile drainage which ceased spontaneously within 3-8 weeks. This study showed that the simple procedure of removal of an endocyst and partial ectocystectomy were suitable for the treatment of hepatic hydatid cysts in children.

Cimetidine increases serum mebendazole concentrations. Implications for treatment of hepatic hydatid cysts.

In eight patients (five with peptic ulcer disease and three with hydatid cysts), the [14C]-aminopyrine breath test (ABT) and maximum serum concentration of mebendazole following a dose of 1.5 g of mebendazole three times daily were determined before and after treatment with cimetidine (400 mg three times daily for 30 days). Serum mebendazole concentrations were measured in blood samples taken 2 h after each drug intake. Cimetidine lowered the 14CO2 specific activity (SA) at 1 h (P less than 0.01) and increased the maximum serum concentration of mebendazole (P less than 0.01). A significant correlation was found between SA at 1 h and the highest concentration of mebendazole before (r = -0.71, P less than 0.05) and after (r = -0.82, P less than 0.05) cimetidine ingestion. Combined administration of cimetidine and mebendazole resulted in the complete resolution of previously unresponsive hydatid cysts.