title: Percutaneous aspiration and drainage with adjuvant medical therapy for treatment of hepatic hydatid cysts.
abstract: OBJECTIVE
  To determine the efficacy and success of percutaneous aspiration irrigation and reaspiration (PAIR) in the management of hepatic hydatidosis.
  
  
  METHODS
  Twenty-six patients with 32 hepatic hydatid cysts had PAIR. Twenty-two patients received at least 2 wk of drug therapy before the procedure was carried out to reduce the risk of recurrence from spillage during the procedure. The procedure was performed under local anesthesia with a 19-gauge 20 cm long needle, the cyst was punctured, cystic content (approximately 30 mL) was aspirated by a 12-14 F pigtail catheter and aspirated fluids were sent for analysis. Once the cyst was almost empty, two-thirds of the net amount of material aspirated was replaced by hypertonic saline and left in the cavity for about 30 min, with the catheter left in place for reaspiration of most of the fluid. When the amount of fluid drained was less than 10 mL per 24 h, the drainage catheter was removed.
  
  
  RESULTS
  All 32 cysts showed evidence of immediate collapse after completion of the procedure, and before discharge from hospital, ultrasound examination showed fluid reaccumulation in all cysts. Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts. To confirm the sterility of these cystic cavities, seven cysts were reaspirated on average 3 mo after the procedure. Investigations revealed no viable scolices.
  
  
  CONCLUSIONS
  PAIR using hypertonic saline is very effective and safe with proper precautions.
authors.affiliation: Department of Internal Medicine, Dammam University Hospital, Al-Khobar 31952, Saudi Arabia. yasawy@hotmail.com
authors.forename: Mohammed I
authors.initials: MI
authors.lastname: Yasawy
authors.forename: Abdelrahman E
authors.initials: AE
authors.lastname: Mohammed
authors.forename: Sammak
authors.initials: S
authors.lastname: Bassam
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Karawi
authors.forename: Sohail
authors.initials: S
authors.lastname: Shariq
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods*; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013396:Suction / Q000379:methods*; D007507:Therapeutic Irrigation; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D015766:Albendazole