title: Percutaneous imaging-guided treatment of hydatid liver cysts: do long-term results make it a first choice?
abstract: OBJECTIVE
  To evaluate the long-term results of percutaneous imaging-guided treatment of hydatid liver cysts.
  
  
  METHODS
  Sixty patients with 77 hydatid liver cysts underwent percutaneous treatment with ultrasonography (US) or computed tomography (CT) guidance. Absolute alcohol and hypertonic saline were used for sclerosing the cysts after aspiration. Prophylactic albendazole treatment was given before and after the procedures. Follow-up US and CT were obtained periodically, and changes in cyst morphology were recorded. Minimum follow-up period for the patients included in this study was 12 months. Serological correlation was also available for a group of patients. The outcome of the procedures were categorized into five groups based on morphological changes observed by imaging.
  
  
  RESULTS
  Procedures were regarded as successful in 80% and unsuccessful in 20% of patients. Failures most often occurred with type III cysts; less than half (39%) of the total type III cysts had a successful outcome. On the other hand, all type I cysts ended up with cure. Anaphylaxis, pneumotorax and severe pain interrupting the procedures were also among the reasons of failure.
  
  
  CONCLUSIONS
  Percutaneous aspiration, injection and reaspiration (PAIR) of types I and II hydatid liver cysts is effective and safe in the long-term. Surgery should no longer be regarded as the first choice treatment in all hydatid liver cysts but should be reserved for type III and certain active type IV cysts.
authors.affiliation: Department of Radiology, Akdeniz University Hospital, Antalya, Turkey. adnank@akdeniz.edu.tr
authors.forename: Adnan
authors.initials: A
authors.lastname: Kabaalioğlu
authors.forename: Kağan
authors.initials: K
authors.lastname: Ceken
authors.forename: Emel
authors.initials: E
authors.lastname: Alimoglu
authors.forename: Ali
authors.initials: A
authors.lastname: Apaydin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000923:Anticestodal Agents / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000627:therapeutic use; D013396:Suction; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000923:Anticestodal Agents; D012462:Saline Solution, Hypertonic; D012597:Sclerosing Solutions; D015766:Albendazole