K Y Polat1, A A Balik, D Oren. 1. Department of General Surgery, Ataturk University, School of Medicine, Erzurum, Turkey. yalcinp@hotmail.com
Abstract
BACKGROUND: Previously surgical operation was the only accepted treatment for hydatid liver cysts. Recently percutaneous management has become more preferable because of its low morbidity rate and lower cost. PATIENTS AND METHODS: In all, 101 patients harbouring 120 hydatid cysts of the liver were treated by percutaneous drainage between October 1994 and December 1997. Of these cysts, 89 were in the right liver and 31 in the left liver.Thirty-one patients had had previous operations for hydatid disease. All cysts had an anechoic or hypoechoic unilocular appearance on ultrasound scan. The mean dimension of the cysts was 7.5+/-2.9 cm (range 3-10.4 cm). All patients received oral albendazole 10 mg/kg perioperatively. After aspiration under sonographic guidance, cysts were irrigated with 95% ethanol. RESULTS: The amount of cyst fluid aspirated was 220+/-75 ml and the amount of irrigation solution used was 175+/-42 ml. Four patients developed mild fever and three had urticaria. Mean length of hospital stay was 2.1+/-0.7 (range 1-4) days, and patients were followed up for 43-62 months (mean 54+/-5.4 months). Maximal cyst diameter decreased from 7.5+/-2.9 cm to 3.2+/-15 cm (p<0.001). Sonographic examinations revealed high-level heterogeneous echoes in the cyst cavity (heterogeneous echo pattern), while the cyst cavity was completely obliterated by echogenic material (pseudotumour echo pattern). DISCUSSION: Most hydatid cysts of the liver can be managed successfully by a combination of drug therapy and percutaneous drainage.
BACKGROUND: Previously surgical operation was the only accepted treatment for hydatid liver cysts. Recently percutaneous management has become more preferable because of its low morbidity rate and lower cost. PATIENTS AND METHODS: In all, 101 patients harbouring 120 hydatid cysts of the liver were treated by percutaneous drainage between October 1994 and December 1997. Of these cysts, 89 were in the right liver and 31 in the left liver.Thirty-one patients had had previous operations for hydatid disease. All cysts had an anechoic or hypoechoic unilocular appearance on ultrasound scan. The mean dimension of the cysts was 7.5+/-2.9 cm (range 3-10.4 cm). All patients received oral albendazole 10 mg/kg perioperatively. After aspiration under sonographic guidance, cysts were irrigated with 95% ethanol. RESULTS: The amount of cyst fluid aspirated was 220+/-75 ml and the amount of irrigation solution used was 175+/-42 ml. Four patients developed mild fever and three had urticaria. Mean length of hospital stay was 2.1+/-0.7 (range 1-4) days, and patients were followed up for 43-62 months (mean 54+/-5.4 months). Maximal cyst diameter decreased from 7.5+/-2.9 cm to 3.2+/-15 cm (p<0.001). Sonographic examinations revealed high-level heterogeneous echoes in the cyst cavity (heterogeneous echo pattern), while the cyst cavity was completely obliterated by echogenic material (pseudotumour echo pattern). DISCUSSION: Most hydatid cysts of the liver can be managed successfully by a combination of drug therapy and percutaneous drainage.