Skip to main content
Top
Published in: Surgical Endoscopy 10/2006

01-10-2006

Percutaneous treatment of univesicular versus multivesicular hepatic hydatid cysts

Authors: E. Zerem, R. Jusufovic

Published in: Surgical Endoscopy | Issue 10/2006

Login to get access

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.
Literature
1.
go back to reference Coyle CM, Wittner M (1999) Parasitic diseases of the liver. In: Lawrence JB (eds). Clinical practice of gastroenterology, Churchill Livingstone, Philadelphia pp 908–921 Coyle CM, Wittner M (1999) Parasitic diseases of the liver. In: Lawrence JB (eds). Clinical practice of gastroenterology, Churchill Livingstone, Philadelphia pp 908–921
2.
go back to reference Milicevic M (1994) Hydatid disease. In: Blumgart LH (eds). Surgery of the liver and biliary tract. 2nd ed. Churchill Livingstone, Edinburgh pp 1121–1150 Milicevic M (1994) Hydatid disease. In: Blumgart LH (eds). Surgery of the liver and biliary tract. 2nd ed. Churchill Livingstone, Edinburgh pp 1121–1150
3.
go back to reference Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20: 795–781PubMed Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20: 795–781PubMed
4.
go back to reference Brunetti E, Maiocchi L, Garlaschelli AL, Gulizia R, Filice C (2004) Overview of therapeutic options for cystic echinococcosis. Parassitologia 46: 53–55PubMed Brunetti E, Maiocchi L, Garlaschelli AL, Gulizia R, Filice C (2004) Overview of therapeutic options for cystic echinococcosis. Parassitologia 46: 53–55PubMed
5.
go back to reference Schipper HG, Kagar PA (2004) Diagnosis and treatment of hepatic echinococcosis: an overview. Scand J Gastroenterol 241(Suppl 1): 50–55CrossRef Schipper HG, Kagar PA (2004) Diagnosis and treatment of hepatic echinococcosis: an overview. Scand J Gastroenterol 241(Suppl 1): 50–55CrossRef
6.
go back to reference 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: 496–500PubMed 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: 496–500PubMed
7.
go back to reference Wagholikar GD, Sikora SS, Kumar A, Saxena R, Kapoor VK (2002) Surgical management of complicated hydatid cysts of the liver. Trop Gastroenterol 23: 35–37PubMed Wagholikar GD, Sikora SS, Kumar A, Saxena R, Kapoor VK (2002) Surgical management of complicated hydatid cysts of the liver. Trop Gastroenterol 23: 35–37PubMed
8.
go back to reference 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: 258–262PubMed 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: 258–262PubMed
9.
go back to reference 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: 171–173PubMed 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: 171–173PubMed
10.
go back to reference Seven R, Berber E, Mercan S, Eminoglu L, Budak D (2000) Laparoscopic treatment of hepatic hydatid cysts. Surgery 128: 36–40PubMedCrossRef Seven R, Berber E, Mercan S, Eminoglu L, Budak D (2000) Laparoscopic treatment of hepatic hydatid cysts. Surgery 128: 36–40PubMedCrossRef
11.
go back to reference Sgourakis G, Gemos K, Dedemadi G, Spetzouris N, Gyftakis H, Salapa P (2001) Laparoscopic drainage of infected hydatid liver cysts. Minerva Chir 56: 169–173PubMed Sgourakis G, Gemos K, Dedemadi G, Spetzouris N, Gyftakis H, Salapa P (2001) Laparoscopic drainage of infected hydatid liver cysts. Minerva Chir 56: 169–173PubMed
12.
go back to reference 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: 789–795PubMedCrossRef 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: 789–795PubMedCrossRef
13.
go back to reference Verma GR, Bose SM (1998) Laparoscopic treatment of hepatic hydatid cyst. Surg Laparosc Endosc 8: 280–282PubMedCrossRef Verma GR, Bose SM (1998) Laparoscopic treatment of hepatic hydatid cyst. Surg Laparosc Endosc 8: 280–282PubMedCrossRef
14.
go back to reference Teggi A, Lastilla MG, De Rosa F (1993) Therapy of human hydatid disease with mebendazole and albendasole. Antimicrob Agents Chemother 37: 1679–1684PubMed Teggi A, Lastilla MG, De Rosa F (1993) Therapy of human hydatid disease with mebendazole and albendasole. Antimicrob Agents Chemother 37: 1679–1684PubMed
15.
go back to reference Horton RJ (1997) Albendazole in treatment of human echinococcosis:12 years of experience. Acta Tropica 64: 79–93PubMedCrossRef Horton RJ (1997) Albendazole in treatment of human echinococcosis:12 years of experience. Acta Tropica 64: 79–93PubMedCrossRef
16.
go back to reference 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: 1452–1459PubMed 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: 1452–1459PubMed
17.
go back to reference Crippa FG, Bruno R, Brunetti E, Filice C (1999) Echinococcal liver cysts treatment with echo-guided percutaneous puncture PAIR. Ital J Gastroenterol Hepatol 31: 884–892PubMed Crippa FG, Bruno R, Brunetti E, Filice C (1999) Echinococcal liver cysts treatment with echo-guided percutaneous puncture PAIR. Ital J Gastroenterol Hepatol 31: 884–892PubMed
18.
19.
go back to reference 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: 83–89PubMed 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: 83–89PubMed
20.
go back to reference 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: 383–389PubMedCrossRef 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: 383–389PubMedCrossRef
21.
go back to reference 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: 423–426PubMed 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: 423–426PubMed
22.
go back to reference Munro BH, Visintainer MA, Page EB (1986) Statistical methods for health care workers. JB Lippincott, Philadelphia Munro BH, Visintainer MA, Page EB (1986) Statistical methods for health care workers. JB Lippincott, Philadelphia
23.
go back to reference WHO Informal Working Group on Echinoccosis (1996) Guidelines for treatment of cystic and alveolar echinococcosis in humans. Bull World Health Organ 74: 231–242 WHO Informal Working Group on Echinoccosis (1996) Guidelines for treatment of cystic and alveolar echinococcosis in humans. Bull World Health Organ 74: 231–242
24.
go back to reference Lewall DB, Mc Crokell SJ (1986) Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol 146: 391–394PubMed Lewall DB, Mc Crokell SJ (1986) Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol 146: 391–394PubMed
25.
26.
go back to reference Smego RA, Jr, Sebanego P (2005) Treatment options for hepatic cystic echinococcosis. Int J Infect Dis 9: 69–76PubMedCrossRef Smego RA, Jr, Sebanego P (2005) Treatment options for hepatic cystic echinococcosis. Int J Infect Dis 9: 69–76PubMedCrossRef
27.
go back to reference Akhan O, Ozmen MN, Dincer A, Sayek IS, Gocman A (1996) Liver hydatid disease: long-term results of percutaneous treatment. Radiology 198: 259–264PubMed Akhan O, Ozmen MN, Dincer A, Sayek IS, Gocman A (1996) Liver hydatid disease: long-term results of percutaneous treatment. Radiology 198: 259–264PubMed
28.
go back to reference 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: 91–96PubMed 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: 91–96PubMed
29.
go back to reference 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: 881–887PubMedCrossRef 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: 881–887PubMedCrossRef
30.
go back to reference Schipper H, Kager PA (1997) Percutaneous drainage of hydatid cysts (letter). New Eng J Med 338: 391–392CrossRef Schipper H, Kager PA (1997) Percutaneous drainage of hydatid cysts (letter). New Eng J Med 338: 391–392CrossRef
31.
go back to reference 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: 984–988PubMed 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: 984–988PubMed
32.
go back to reference 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: 220–224PubMedCrossRef 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: 220–224PubMedCrossRef
33.
go back to reference 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: 314–316PubMed 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: 314–316PubMed
Metadata
Title
Percutaneous treatment of univesicular versus multivesicular hepatic hydatid cysts
Authors
E. Zerem
R. Jusufovic
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 10/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-0135-z

Other articles of this Issue 10/2006

Surgical Endoscopy 10/2006 Go to the issue