Percutaneous treatment of hepatic hydatid cyst in pregnancy: long-term results.
OBJECTIVE
To present the long-term results of percutaneous treatment of hepatic hydatid cyst in pregnancy.


METHODS
Six pregnant patients (age range 19-28 years; mean age 23 years) with six hepatic hydatid cysts underwent percutaneous treatment without albendazole prophylaxis. Puncture, aspiration, injection and reaspiration (PAIR technique) were used to treat the cysts. Hypertonic saline solution was used as cytotoxic agent. Follow-up was mainly by sonography every 2 weeks during pregnancy, every third month post-partum for the first year, every 6 months for the second year, and once a year thereafter. The mean follow-up time was 57.5 months.


RESULTS
Before the treatment, average hydatid cyst volume was 2,145 ml that was reduced to 145 ml post-treatment at the time of delivery. The first five cases of the study had solid appearance of the cyst remnant (indicating complete cure) in 22 months. Cystobiliary fistula was suspected in the sixth case three months after delivery. After confirmation of the cystobiliary fistula with cystography, a percutaneous catheter was placed into the postresidual cavity and a nasobiliary catheter was placed into the common bile duct after syphincterotomy. The fistula was closed in 2 weeks. This patient has a follow-up time of 1 year so far without any problem. No mortality, morbidity, fetal loss, abdominal dissemination, or tract seeding was observed among our cases.


CONCLUSIONS
Percutanous treatment of hydatid cysts in pregnancy is an efficient and safe procedure in cases where percutaneous treatment is indicated.
Ustunsoz
Bahri
B
Department of Radiology, Faculty of Medicine, Gulhane Military Medical Academy, Etlik, 06018 Ankara, Turkey. bustunsoz2000@yahoo.com
Ugurel
Mehmet Sahin
MS
Uzar
Ali Ihsan
AI
Duru
Namik Kemal
NK
D000279:Administration, Cutaneous; D000328:Adult; D004322:Drainage; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000000981:diagnostic imaging / Q000628:therapy*; D011677:Punctures; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D007507:Therapeutic Irrigation; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D012462:Saline Solution, Hypertonic