Echinococcus granulosus infection: the challenge of surgical treatment

Buttenschoen, Klaus; Buttenschoen, Daniela Carli

doi:10.1007/s00423-003-0397-z

Cited by 120 publications

(131 citation statements)

References 73 publications

(99 reference statements)

Supporting

Mentioning

122

Contrasting

Unclassified

Order By: Relevance

“…These procedures eventually eradicate the entire parasite, resulting in a complete cure without recurrence. However, the technical procedures remain controversial (27) .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, mortality and morbidity were remarkably higher with the radical procedures than with the conservative surgical option. A previous meta-analysis reported rates for mortality of 2%, morbidity of 23%, and recurrence of 10.4% with radical operations (27) , and the authors suggested that procedures that remove the parasite and retain the pericyst are easier to conduct than radical methods. Moreover, many surgeons consider that the radical methods are too radical for a benign disease (11) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Abdelraouf

El-Aal

Shoeib

et al. 2015

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Introduction: Hydatidosis is the result of infection with the larval stages of some species of the genus Echinococcus. Treatment approaches for hydatid cysts include the use of albendazole, surgery, and/or medico-surgical procedures. The choice of the therapeutic surgical approach depends on the cyst number and localization, surgeon expertise, and presence of complications. The present study aimed to compare the outcomes of the following therapeutic approaches for the treatment of hepatic hydatid cysts: pericystectomy; the puncture, aspiration, injection, and reaspiration (PAIR) technique; and the PAIR technique followed by deroofi ng, evacuation of cysts, and omentoplasty. Methods: The 54 patients were divided into 3 groups: Group I (14 patients) who underwent pericystectomy, Group II (23 patients) who underwent the PAIR technique, and Group III (17 patients) who underwent the PAIR technique followed by deroofi ng and omentoplasty. The diagnosis of hydatid cysts was based on serological testing using enzyme-linked immunosorbent assay, abdominal ultrasound, and parasitological examination of the cyst contents. Morbidity, mortality, length of hospital stay, recurrence, and postoperative complications were evaluated. Results: Postoperative bleeding, infection, and recurrence were reported in Groups I and II; Group III did not experience postoperative infection and had shorter hospital stays. Recurrence and postoperative complications did not occur in Group III. Conclusions: The partial surgical procedure with deroofi ng, evacuation of the cysts, and omentoplasty, as performed in the present study, is recommended as a safe and effective method for elimination of the entire parasite with minimal possibility for intra-peritoneal spillage.

show abstract

“…These procedures eventually eradicate the entire parasite, resulting in a complete cure without recurrence. However, the technical procedures remain controversial (27) .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Abdelraouf

El-Aal

Shoeib

et al. 2015

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

show abstract

“…These procedures are eventually targeting the entire eradication of the parasite for complete cure without recurrence. However, the technical procedures are still a matter of controversy [27].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, many surgeons considered these radical methods are too radical for a benign disease [11]. The meta-analysis done by other investigators revealed a mortality of 2%, morbidity of 23% and recurrence rate of 10.4% for such radical types of operations [27]. These authors considered the procedures that remove the parasite and keep the pericyst are easier to carry out than radical ones.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Serological Outcomes in Different Surgical Approaches for Hepatic Human Hydatidosis

Abdin¹

2015

J Bacteriol Parasitol

View full text Add to dashboard Cite

show abstract

“…This approach is becoming more widely used and actually PAIR plus drug therapy represents the first recommended approach, mainly for uncomplicated cysts with a limited number of daughter cysts, with diameter until 7-8cm, for the reported low complication rate and because it don't hamper surgical treatment of refractory cysts. The role of surgery is progressively narrowing, being confined to the most complicated cases that require more surgical expertise [6][7][8][9]. Surgery needs to be effective to inactivate scolices, preventing recurrence and spillage into the abdomen and to obliterate the residual cavity in order to decrease the rate of post-operative complications.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2017

JLRDT

View full text Add to dashboard Cite

Introduction: Liver echinococcosis is still an endemic disease in Balkans. PAIR is actually considered the safest therapeutically approach for uncomplicated type I and II cysts, while surgery is indicated for type III or complicated cysts. It's commonly believed that radical surgery could be considered the most appropriate treatment for hydrated disease, but with higher risk of morbidity, much more for centrally located cysts, especially in low-resources hospitals.Aim of the study: According with the tendency in western countries and within a training project leaded by Veneto Region -Italy, we started in cooperation with the Division of Surgery of Peja Hospital Kosovo a prospective study to assess the safety and effectiveness of radical surgery also for centrally located cysts, when PAIR was contraindicated. Materials and Methods:From Feb 2006 to Apr 2010, 10 consecutive patients (6 Female, 4 males, mean age 31, 3± 14 yrs, range 8-54) with 16 cysts were treated for echinococcal liver disease in Surgical Division of Peja Hospital, Kosovo. All patients received Albendazole before operation and in the perioperative period. Medical therapy was discontinued the day after operation. One patient had recurrent echinococcal cysts after previous operation of partial cystectomy and T-tube placement in the biliary duct. Patients were classified to have peripherical (n=1) or centrally (n=9) located cysts when at least one of them was in close relationship with the main vascular and biliary structures. Other than laboratory tests, preoperative evaluation included in all patients abdominal ultrasound and CT scan.Results: Nine pts with 15 cysts underwent radical surgery and 1 patient underwent non radical operation (1 subtotal pericystectomy). Four of them had multiple cysts. Mean operative time was 236 min. Mean postoperative stay was 5, 2± 2, 52 days (range 3-10). No intra or postoperative complications were observed after radical surgery. A bile leak that healed spontaneously after 9 days occurred in patient with subtotal pericystectomy. Mean follow-up is longer than 3 years. Discussion: Therapeutic choices for echinococcal liver disease depend from factors related to patient, cyst, availability of resources and physician. Radical surgery is considered the treatment of choice because of complete elimination of the parasite and the residual cavity, minimizing the risk of recurrence. This approach, especially for central cysts, must be balanced with the risk of complications, but it's the preferred one in Centers with expertise in liver surgery and it was possible in 93% of cases in this series. In our experience mean operative time was prolonged because of meticulous dissections of cysts from surrounding tissue and vessels. It was always possible to dissect the main veins from pericystium, while portal triad structures were more often eroded by the cysts and needed to be sutured. Mean follow-up is more than 3 years and no recurrences were observed until now. Conclusion:Open radical surgery can be considered a reliable...

show abstract

Echinococcus granulosus infection: the challenge of surgical treatment

Cited by 120 publications

References 73 publications

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Clinical and serological outcomes with different surgical approaches for human hepatic hydatidosis

Clinical and Serological Outcomes in Different Surgical Approaches for Hepatic Human Hydatidosis

Untitled

Contact Info

Product

Resources

About