Title:Percutaneous Treatment of Hydatid Liver Cysts: An Update
Volume: 7
Issue: 3
Author(s): Antonio Giorgio, Giorgio Calisti, Giorgio de Stefano, Nunzia Farella, Umberto Scognamiglio and Valentina Giorgio
Affiliation:
Keywords:
D-PAI, Hepatic echinococcosis, liver hydatidosis, liver hydatid cysts, PAIR, percutaneous treatment, radiofrequency
ablation, Echinococcus granulosus, scolicidal agent, PERCUTANEOUS TECHNIQUES
Abstract: Liver hydatidosis is the most common clinical presentation of cystic echinococcosis. Although liver cystic hydatidosis
is considered a benign disease and many patients do not develop symptoms for years, its complications can be
severe and life threatening (usually as a consequence of rupture in the biliary tree, in the peritoneum, in the bronchi, and
of anaphylactic shock), thus, treatment is recommended for all viable and active hydatid liver cysts. Among the therapeutical
options available for this disease, such as open and laparoscopic surgery and chemotherapy, percutaneous treatments
have gained considerable interest over the last two decades, due to their efficacy, safety and high patient acceptability.
Percutaneous treatments for liver cystic hydatidosis were once discouraged due to the risk of anaphylaxis following cyst
puncture. Following the first uneventful attempts in the mid ’80’s, these treatments were increasingly used and techniques
such as PAIR (Puncture, Aspiration, Injection, Re-aspiration) and its variants were developed and implemented in clinical
practice. Although the evidence currently available is not sufficient to support or refuse the superiority of PAIR in terms
of efficacy, numerous studies have demonstrated that it carries lower rates of morbidity, mortality, and disease recurrence
and is associated with shorter hospital stays compared with surgery.
The present review provides a brief history of percutaneous treatments for liver cystic hydatidosis, summarizes the currently
available evidence on the subject, gives a brief overview of potential future developments in this field focusing on
radiofrequency ablation techniques and presents some new patents on the issue.
