Hydatid liver cyst - An 11-year experience of treatment with percutaneous aspiration and ethanol injection

Objective. To report an Ii-year experience of treatment of hydatid liver cysts with double percutaneous aspiration and inject on of alcohol. Methods. Of the 129 patients with 174 hydatid liver cysts admitted to our department between January 1988 and January 1999, 79 patients with 119 vital hydatid liver cysts were selected for double percutaneous aspiration and injection of alcohol. Under ultrasonographic guidance, cystic cavities were first drained through fine needles, and then 95% sterile ethanol was injected and left in situ. The same procedure was repeated 3 days later without re-aspiration of the injected alcohol. General anesthesia without endotracheal intubation was performed in 21 selected cases. Results. Double percutaneous aspiration and injection of alcohol was completed in 78 patients with 118 hydatid liver cysts. In 1 case the procedure could not be accomplished because of an intracystic hemorrhage. A total of 254 punctures were performed, and the ethanol injected per session ranged between 12 and 250 ml.. The mean hospital stay was 2.9 days (range, 2-7 days). The overall median follow-up was 48 months (range, 6-122 months). At the last ultrasonographic examination, 45.8% of the treated hydatid liver cysts had a solid pattern, 47.4% were no longer appreciable, and 6.8% had a minimal liquid component. Intracystic relapse occurred in 5% of the patients. In no case were any new cysts observed either in different hepatic segments or in any extrahepatic location. The morbidity rate was 9%, and 1 death occurred (mortality rate, 1.3%). Conclusions. Over a long period, double percutaneous aspiration and injection of alcohol proved to be a substantially safe, effective, and low-cost procedure for hydatid liver cyst treatment.