Endoscopic Management of Biliary Hydatid Disease: Report on Six Cases

Abstract

Six patients with a ruptured Echinococcus liver cyst were treated by means of endoscopy. The treatment consisted of endoscopic sphincterotomy, cyst material extraction and hypotonic saline lavage via a nasobiliary catheter. In five patients successful complete endoscopic treatment was achieved, including removal of daughter cysts. In the sixth patient only partial treatment could be performed with clearance of daughter cysts since there was no communication with the main liver cyst. Follow-up ultrasonography, CT and ERCP in all patients showed complete cure and no evidence of disease recurrence in five of them. The sixth patient required surgery one month after endoscopic treatment of the acute biliary obstruction.

Treatment of hepatic hydatid disease complications using endoscopic retrograde cholangiopancreatography procedures

“…23,24 Endoscopic sphincterotomy, clearance of the biliary tract and stent placement is the treatment of choice in patients with severe cholangitis. 22 In the present series, all 7 patients with postoperative obstructive jaundice or cholangitis had cyst remnants in the …”

“…Although uncommon in such patients, echinococcal material or even stones may be present in the bile duct. As suggested by al Karawi and colleagues, 22 ERCP enables clearance of such debris from the ducts by using a balloon catheter, Dormia basket or irrigation with hypertonic saline solution by means of a naso biliary drain. However, because of the risk of sclerosing cholangitis, lavage is not performed with any scolicidal agents.…”

Hydatid Disease: Current Status and Recent Advances

“…The cyst regresses and disappears over the next 4-6 weeks. 12,20,44,51 Laparoscopic removal of hepatic cysts have been reported and liver transplant has been performed in extensive hepatic hydatidosis not amenable to surgical resection. None of these modalities have been evaluated in controlled trials.…”

Management of Giant Hydatid Liver Disease: A Case Report and Review of Literature

“…According to the Ministry of Health database, there are 14000 cases recorded from 2001 to 2005 in Turkey (1). The liver is involved in 50%-70% of cases (2,(3)(4)(5). A 14-year-old boy with a giant echinococcal cyst occupying 2/3 of the right lobe of the liver was surgically treated using polyglicolic acid sheet (PGA).…”