Current interventional strategy for the treatment of hepatic alveolar echinococcosis.
The use of various types of invasive interventions combined with anti-infective drugs in the therapeutic strategy of alveolar echinococcosis (AE) has changed during the last 30 years. Areas covered: This article reviews the current respective indications of surgical, percutaneous and perendoscopic interventions in AE and proposes an integrative therapeutic strategy. Expert commentary: Hepatic resection is indicated whenever it is feasible and curative; palliative surgery should be avoided; percutaneous procedures are best adapted to the drainage of the necrotic cavity present in advanced cases; perendoscopic procedures with stenting are best adapted to alleviating the biliary complications that are common and life-threatening in AE patients. Continuous administration of albendazole or mebendazole, without interruption is mandatory in all cases, temporarily (recommended duration: 2 years) after radical lesion resection in patients without immune suppression; for life in all other cases. Long-term follow-up is essential.
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Dominique A
DA
Vuitton
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Amel
A
Azizi
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Carine
C
Richou
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Lucine
L
Vuitton
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Oleg
O
Blagosklonov
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Eric
E
Delabrousse
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Georges A
GA
Mantion
a WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis & French National Centre for Alveolar Echinococcosis (Director: Laurence Millon) , University of Franche-Comté and University Hospital , Besançon , France.
Solange
S
Bresson-Hadni
D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D004334:Drug Administration Schedule; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D004446:Echinococcus / Q000187:drug effects / Q000302:isolation & purification; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008463:Mebendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D008463:Mebendazole; D015766:Albendazole
Alveolar echinococcosis; Echinococcus multilocularis; cholangitis; endoscopic retrograde cholangio-pancreatography (ERCP); ex-vivo liver resection; hepatectomy; liver allo-transplantation; liver auto-transplantation; per-endoscopic biliary drainage and stenting; percutaneous transhepatic biliary drainage