The liver involvement of the hydatid disease: a systematic review designed for the hepato-gastroenterologist.

Hydatidosis is not uncommon in Western Europe, mainly due to the presence of immigrants from endemic countries, and hepato-gastroenterologist must then be able to manage this infectious disease. The hepatic hydatidosis is due to development in the liver of the larvae of Echinococcus granulosus that causes liver cysts. It can grow in size throughout the years and can give rise to complications, mainly pain, super-infection or cyst rupture. Recent progresses in imaging modalities play an important role in diagnosis, classification and evaluation of response to treatment of the cysts. Imaging techniques led to both Gharbi's and WHO's classifications. Those can provide markers of cyst activity and can help to determine the best therapeutic strategy. By combining two immunodiagnostic techniques, the diagnostic accuracy of laboratory tests is excellent. During the last decade, treatment has improved : the main therapeutic modality in the past was surgery, until the discovery of PAIR procedure (Puncture, Aspiration, Injection, Re-aspiration). Albendazole also plays an important role in the treatment of hydatid cysts either alone or as a pre-procedure or post procedure prophylaxis. This review will cover the major aspects of the disease emphasizing the recent diagnostic and therapeutic advances.