title: Clinical and sonographic management of viable hydatid liver cysts.
abstract: OBJECTIVE
  The aim of this study was to review our 18-year experience in the treatment of viable hydatid liver cysts (HLCs) with double percutaneous aspiration and ethanol injection (D-PAI) and to provide indications for the clinical management of HLCs.
  
  
  METHODS
  From January 1989 to December 2007, 127 patients (100 males; 13-80 years) with 184 viable HLCs (137 univesicular, 47 multivesicular; 2.8-20 cm) underwent D-PAI.
  
  
  RESULTS
  Ultrasonography (US) showed complete disappearance of 125/184 (68%) cysts; in the remaining 59 cases, an inactive solid (37 cases, 20%) or liquid pattern (22 cases, 12%) was observed with volume decreases of 50-80%. The final US pattern was unmodified during the follow-up in 96.8%. Local recurrences were observed in 5 patients (3.9%): 4 patients with 8 multivesicular cysts and 1 patient with a bilocular cyst (with a solid pattern on US) that ruptured into the biliary tree 2 years after the procedure and disappeared after endoscopic sphincterectomy. The mortality rate was 0.8%, and the overall morbidity was 8.6%. The mean hospital stay was 2.9 days. The time of healing for smaller cysts (<5 cm) was shorter than that of large cysts (≥5 cm) (P < 0.001).
  
  
  CONCLUSIONS
  Our long-term results confirm the high effectiveness of D-PAI in the treatment of HLCs. These results suggest that multilocular cysts require closer follow-up than unilocular cysts.
authors: Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Naples, Italy.
authors: A
authors: A
authors: Giorgio
authors: G
authors: G
authors: de Stefano
authors: A
authors: A
authors: Di Sarno
authors: G
authors: G
authors: Liorre
authors: U
authors: U
authors: Scognamiglio
authors: S
authors: S
authors: Iaquinta
authors: A
authors: A
authors: Mariniello
authors: V
authors: V
authors: Giorgio
authors: M
authors: M
authors: de Stefano
authors: A
authors: A
authors: Perrotta
keywords: Double percutaneous aspiration and ethanol injection; Hydatid liver cysts; Interventional ultrasound; Percutaneous treatment; Puncture–aspiration–injection and re-aspiration
references: Dig Dis Sci. 1994 Jul;39(7):1576-80
references: 8026272
references: Am J Surg. 2004 Apr;187(4):533-7
references: 15041506
references: World J Surg. 2004 Aug;28(8):731-6
references: 15457348
references: Ann Parasitol Hum Comp. 1986;61(6):689-92
references: 3566087
references: Radiology. 1996 Jan;198(1):259-64
references: 8539390
references: Cardiovasc Intervent Radiol. 1990 Jun-Jul;13(3):169-73
references: 2121344
references: Acta Radiol. 2004 Jul;45(4):383-9
references: 15323389
references: World J Surg. 2005 Dec;29(12):1670-9
references: 16311852
references: Int J Infect Dis. 2005 Mar;9(2):69-76
references: 15708321
references: Infection. 2008 Jun;36(3):256-61
references: 18473119
references: AJR Am J Roentgenol. 1999 Jan;172(1):91-6
references: 9888746
references: Ann Surg. 1984 Apr;199(4):412-7
references: 6712316
references: J Hepatol. 1997 Jun;26(6):1408-12
references: 9210631
references: J Ultrasound Med. 2001 Jul;20(7):729-38
references: 11444731
references: Radiology. 1992 Sep;184(3):705-10
references: 1509053
references: Gastroenterol Clin North Am. 1996 Sep;25(3):655-89
references: 8863045
references: N Engl J Med. 1997 Sep 25;337(13):881-7
references: 9302302
references: AJR Am J Roentgenol. 1999 Jan;172(1):83-9
references: 9888745
references: Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6):1112-6
references: 17533534
references: Gastroenterology. 1993 May;104(5):1452-9
references: 8482455