Percutaneous treatment of hydatid cysts of the liver:: Long-term results

被引:130
作者
Üstünsöz, B
Akhan, O
Kamiloglu, MA
Somuncu, I
Ugurel, MS
Çetiner, S
机构
[1] Gulhane Mil Med Acad, Dept Radiol, TR-06100 Ankara, Turkey
[2] Gulhane Mil Med Acad, Dept Surg, TR-06100 Ankara, Turkey
[3] Hacettepe Univ, Fac Med, Dept Radiol, TR-06100 Ankara, Turkey
关键词
D O I
10.2214/ajr.172.1.9888746
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The purpose of the study was to present the long-term results of percutaneous treatment of liver hydatid cysts. SUBJECTS AND METHODS, Seventy-two patients (44 male and 28 female, ranging in age between 10 and 69 years; mean age, 35 years) with 106 liver hydatid cysts underwent percutaneous treatment with albendazole prophylaxis. Puncture, aspiration, injection, and reaspiration (PAIR) were used for hydatid cysts smaller than 6 cm (n = 66). Larger cysts (n = 40) were treated by catheterization. Hypertonic saline solution and absolute alcohol were used as the cytotoxic and sclerosing agents. Sonographic guidance with or without fluoroscopy was used in all patients. Follow-up was mainly by sonography every third month of the first year, every sixth month of the second year, and once a year thereafter. The mean followup time was 37 months. RESULTS. The mean reduction in volume at the time of the first follow-up was 87.0% and 73.5% in catheterization and PAIR patients, respectively. The immediate sonographic changes after treatment were detachment of the endocyst and disappearance of the regular endocyst, with a reduction in the fluid component. The solid appearance of the cyst remnant indicated complete cure as the cyst wall became irregular and thicker. The average time for development of a solid appearance was 19 months in PAIR patients and 26 months in catheterization patients. Seventy of 72 patients were cured, whereas two recurrences (2.8%) were observed. No mortality, abdominal dissemination, or tract seeding occurred. Minor complications were urticaria and fever in eight patients (11.1%). Major complications were infection of the cyst cavity in two patients (2.8%) and development of biliary fistula in four patients (5.6%). Mean hospitalization times were 17 days for complicated cases and 1 day for uncomplicated cases. CONCLUSION, The long-term results of percutaneous liver hydatid cyst treatment accord with shea-term results, indicating that the procedure is efficient and safe and offers complete cure in selected patients with a short hospitalization.
引用
收藏
页码:91 / 96
页数:6
相关论文
共 34 条
[1]   PURELY CYSTIC HYDATID-DISEASE OF THE LIVER - TREATMENT WITH PERCUTANEOUS ASPIRATION AND INJECTION OF HYPERTONIC SALINE [J].
ACUNAS, B ;
ROZANES, I ;
CELIK, L ;
MINARECI, O ;
ACUNAS, G ;
ALPER, A ;
ARIOGUL, O ;
GOKMEN, E .
RADIOLOGY, 1992, 182 (02) :541-543
[2]  
AKHAN O, 1994, CARDIOVASC INTER RAD, V17, P271
[3]   Liver hydatid disease: Long-term results of percutaneous treatment [J].
Akhan, O ;
Ozmen, MN ;
Dincer, A ;
Sayek, I ;
Gocmen, A .
RADIOLOGY, 1996, 198 (01) :259-264
[4]   PERCUTANEOUS TREATMENT OF ABDOMINAL HYDATID CYSTS WITH HYPERTONIC SALINE AND ALCOHOL - AN EXPERIMENTAL-STUDY IN SHEEP [J].
AKHAN, O ;
DINCER, A ;
GOKOZ, A ;
SAYEK, I ;
HAVLIOGLU, S ;
ABBASOGLU, O ;
ERYILMAZ, M ;
BESIM, A ;
BARIS, I .
INVESTIGATIVE RADIOLOGY, 1993, 28 (02) :121-127
[5]  
Akkiz H, 1996, CAN J SURG, V39, P287
[6]  
AKTAN AO, 1993, ACTA CHIR BELG, P151
[7]   NONSURGICAL ENDOSCOPIC TRANS-PAPILLARY TREATMENT OF RUPTURED ECHINOCOCCUS LIVER CYST OBSTRUCTING THE BILIARY TREE [J].
ALKARAWI, MA ;
MOHAMED, ARE ;
YASAWY, I ;
HALEEM, A .
ENDOSCOPY, 1987, 19 (02) :81-83
[8]   HYDATID DISEASE OF LIVER [J].
BARROS, JL .
AMERICAN JOURNAL OF SURGERY, 1978, 135 (04) :597-600
[9]   PERCUTANEOUS TREATMENT OF HYDATID CYSTS UNDER SONOGRAPHIC GUIDANCE [J].
BASTID, C ;
AZAR, C ;
DOYER, M ;
SAHEL, J .
DIGESTIVE DISEASES AND SCIENCES, 1994, 39 (07) :1576-1580
[10]  
Ben Amor N, 1986, Tunis Med, V64, P325