[Percutaneous ultrasound-guided fine needle puncture of parasitic liver cysts: risks and benefits].
OBJECTIVE
Percutaneous drainage (PD) has been used successfully in the percutaneous drainage of hepatic hydatid cysts in spite of discouragement by some authors from potential complications such as anaphylactic shock or seeding due to spillage. The aim of this meta-analysis was to evaluate the safety and efficacy of this new form of treatment and to develop a rational approach to the management of liver hydatosis by ultrasound guided PD.


METHODS
Relevant articles published in English, French and German from 1983 to 1993 were identified through a computer search of data on the clinical manifestations, complications, anthelmintic treatment in combination with PD and on recurrence rate.


RESULTS
104 hydatid cysts treated by US-guided PD were published in literature. In 25% of the cases diagnosis was unsuspected prior to PD. None of these patients developed serious complications. All symptomatic patients were relieved of symptoms. None of the patients needed surgery. The complication rate was 14.4% and mortality was zero. Anthelmintic drug treatment in combination with PD showed no reduction of side effects. No recurrences were reported during follow-up (3-31 months).


CONCLUSIONS
With proper patient monitoring US-guided PD can be recommended as a routine diagnostic and therapeutic tool in liver hydatosis.
Medizinische Klinik II, Stätdischen Kliniken Darmstadt.
M
M
Kohlhäufl
D000871:Anthelmintics / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004322:Drainage / Q000295:instrumentation; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D004869:Equipment Safety; D006801:Humans; D011677:Punctures / Q000295:instrumentation*; D012008:Recurrence; D014463:Ultrasonography / Q000295:instrumentation*
D000871:Anthelmintics
Perkutane sonographisch gesteuerte Feinnadelpunktion parasitärer Leberzysten: Risiko und Nutzen.