Percutaneous treatment of the liver hydatid cysts
Articol din publicatia Timisoara Medical Journal nr.4/2004
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Ciprian Duta, Caius Lazar, Doru Bordos
Surgical Clinic II, University of Medicine and Pharmacy V.Babes Timisoara
Ciprian Duta, M.D., Ph.D., Apateu 25, Timisoara 1900, Tel: 0722-356232, Fax: 0256-289171, Email: firstname.lastname@example.org Abstract
The purpose of the study was to present our experience with ultrasound (US)-guided percutaneous treatment of hydatid abdominal cysts. From April 1996 to April 2002, 118 patients with 135 liver hydatid cysts (49 men and 69 women), with a mean age of 40.6 years (range 7 - 68 yr.) were treated with PAIR (puncture, aspiration, injection, re-aspiration) technique.
Absolute alcohol was used as the cytotoxic and sclerosing agent. Sonographic guidance was used in all patients. The patients were selected from CL, CE1 CE2 after WHO-IWGE classification. All patients were treated with antihelmintic drugs started with 24 hours before puncture and for at least one month after the procedure. All the patients were successfully treated and the mean follow-up time was 39.7 +/- 12.5 months. Postoperative evaluation including ultrasound, computed tomography and serology tests showed no local recurrence or spread of the disease. The mean reduction in volume was 87.0% after 1 year. Only 6 cysts recurred after 6 month to 2 years and were treated again by PAIR. Major complications were infection of the cyst cavity in 1 patient and development of biliary fistula in 3 patients. In all other cases detachment of the germinal membrane and complete transformation of the cyst were observed after 1 month to 2 years. Minor complications were urticaria and fever in 6 patients. Mean hospitalization was 3.6 days. The long-term results of percutaneous liver hydatid cyst treatment indicate that the procedure is efficient and safe and offers complete cure in selected patients, with short hospitalization.
Key Words: liver, hydatidosis, percutaneous treatment