Percutaneous treatment of liver hydatid cysts: comparison of direct injection of albendazole and hypertonic saline solution.
OBJECTIVE
The purpose of this study was to compare the effect of intracystic injection of albendazole and hypertonic saline in patients with liver hydatid disease.


METHODS
Fifty-nine patients with a total of 109 hydatid cysts were treated percutaneously. In all cases, local anesthesia was applied. Twenty percent hypertonic saline was used in 31 patients (40 cysts, group 1) as the scolicidal agent, and albendazole solution was used in 28 patients (69 cysts, group 2). The PAIR (percutaneous puncture, aspiration, injection, reaspiration) method was applied in group 1. In group 2, we used a different procedure that could be called the PAI (percutaneous aspiration and injection) method. After this procedure, routine sonography and CT examinations were conducted. The results of both groups were compared.


RESULTS
Follow-up examinations showed that liver hydatids expanded approximately to their original size after a significant reduction during the first month. In the follow-up period, fluid contents totally disappeared; thickening and irregularities were also observed in the cyst walls and a solid, hyperechogenic, heterogeneous pseudotumor appearance representing a degenerated membrane was seen in all patients. Hypertonic saline solution inactivated the scolices from the beginning of the treatment. However, scolices were inactive in the cysts aspirated 1 month after the procedure in group 2. A significant correlation was noted between elapsed time after the treatment and the cyst size using Wilcoxon's signed rank test (p = 0.000). No difference was seen between two groups in the amount of cyst size reduction using the Mann-Whitney test (p =0.521).


CONCLUSIONS
In addition to its oral use, albendazole may be injected intracystically as we did in our study. It sterilizes the cyst cavity and affects scolices as well.
Paksoy
Yahya
Y
Department of Radiology, Selcuk University, Meram School of Medicine, Konya, Turkey. yahyapaksoy@yahoo.com
Odev
Kemal
K
Sahin
Mustafa
M
Arslan
Ahmet
A
Koç
Osman
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
D000871:Anthelmintics; D012462:Saline Solution, Hypertonic; D015766:Albendazole