Percutaneous treatment of hydatid cysts of the liver: long-term results.
OBJECTIVE
The purpose of the study was to present the long-term results of percutaneous treatment of liver hydatid cysts.


METHODS
Seventy-two patients (44 male and 28 female, ranging in age between 10 and 69 years; mean age, 35 years) with 106 liver hydatid cysts underwent percutaneous treatment with albendazole prophylaxis. Puncture, aspiration, injection, and reaspiration (PAIR) were used for hydatid cysts smaller than 6 cm (n = 66). Larger cysts (n = 40) were treated by catheterization. Hypertonic saline solution and absolute alcohol were used as the cytotoxic and sclerosing agents. Sonographic guidance with or without fluoroscopy was used in all patients. Follow-up was mainly by sonography every third month of the first year, every sixth month of the second year, and once a year thereafter. The mean follow-up time was 37 months.


RESULTS
The mean reduction in volume at the time of the first follow-up was 87.0% and 73.5% in catheterization and PAIR patients, respectively. The immediate sonographic changes after treatment were detachment of the endocyst and disappearance of the regular endocyst, with a reduction in the fluid component. The solid appearance of the cyst remnant indicated complete cure as the cyst wall became irregular and thicker. The average time for development of a solid appearance was 19 months in PAIR patients and 26 months in catheterization patients. Seventy of 72 patients were cured, whereas two recurrences (2.8%) were observed. No mortality, abdominal dissemination, or tract seeding occurred. Minor complications were urticaria and fever in eight patients (11.1%). Major complications were infection of the cyst cavity in two patients (2.8%) and development of biliary fistula in four patients (5.6%). Mean hospitalization times were 17 days for complicated cases and I day for uncomplicated cases.


CONCLUSIONS
The long-term results of percutaneous liver hydatid cyst treatment accord with short-term results, indicating that the procedure is efficient and safe and offers complete cure in selected patients with a short hospitalization.
Ustünsöz
B
B
Department of Radiology, Gülhane Military Medical Academy, Ankara, Turkey.
Akhan
O
O
Kamiloğlu
M A
MA
Somuncu
I
I
Uğurel
M S
MS
Cetiner
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization; D002648:Child; D004322:Drainage; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D012462:Saline Solution, Hypertonic