Evaluation of treatment and long-term follow-up in patients with hepatic alveolar echinococcosis

Kadry, Zakiyah; Renner, Elisabeth C.; Bachmann, Lucas M.; Attigah, Nicolas; Ammann, Rudolf W.; Clavien, Pierre‐Alain

doi:10.1002/bjs.4998

Cited by 99 publications

(86 citation statements)

References 21 publications

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“…More seriously, many patients lack the inclination to visit a hospital for therapy because HAE is considered a benign disease with no significant symptoms. Therefore, these patients lose the best chances for radical resection in the early stage HAE, and they must undergo treatment with oral albendazole tablets or palliative external drainage without an alternative treatment option 8, 9, 10…”

Section: Discussionmentioning

confidence: 99%

“…Palliative surgery, such as lesion reduction surgery or cholangial drainage, does not notably benefit patient survival. Oral chemotherapy, such as albendazole, may postpone HAE progression, but the results are still far from satisfactory 8, 9, 10. Liver transplantation (LT) has been applied as the last‐resort therapy and as the only opportunity for radical cure of HAE since 1985 7, 11.…”

Section: Introductionmentioning

confidence: 99%

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Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Yang

Qiu

Huang

et al. 2018

American Journal of Transplantation

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Ex vivo liver resection combined with autotransplantation is a recently introduced approach to cure end‐stage hepatic alveolar echinococcosis (HAE), which is considered unresectable by conventional radical resection due to echinococcal dissemination into the crucial intrahepatic conduits and adjacent structures. This article aims discuss the manipulation details and propose reasonable indications for this promising technique. All patients successfully underwent liver autotransplantation with no intraoperative mortality. The median weight of the autografts was 636 g (360‐1300 g), the median operation time was 12.5 hours (9.4‐19.5 hours), and the median anhepatic phase was 309 minutes (180‐ 460 minutes). Intraoperative blood loss averaged 1800 mL (1200‐6000 mL). Postoperative complications occurred in 13 patients during hospitalization; 5 patients experienced postoperative complications classified as Clavien‐Dindo grade III or higher, and 2 patients died of intraabdominal bleeding and acute cerebral hemorrhage, respectively. Twenty‐nine patients were followed for a median of 14.0 months (3‐42 months), and no HAE recurrence was detected. The technique requires neither an organ donor nor any postoperative immunosuppressant, and the success of the treatment relies on meticulous preoperative assessments and precise surgical manipulation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Yang

Qiu

Huang

et al. 2018

American Journal of Transplantation

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“…They include primarily albendazole (Zentel; Smith-Kline Beecham) and mebendazole (Vermox; Janssen Pharmaceutica, Beerse, Belgium) (4). As experienced with the treatment of echinococcosis (58), albendazole has the slight advantage that most patients reach requested plasma levels and thus do not require monitoring, while mebendazole plasma levels can vary considerably among different patients and might require individual monitoring and dosing (65). Secondarily, pyrantel (Combantrin; Pfizer) can also be used (29).…”

Section: Treatment Of Trichinellosis In Humansmentioning

confidence: 99%

Epidemiology, Diagnosis, Treatment, and Control of Trichinellosis

2009

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SUMMARY Throughout much of the world, Trichinella spp. are found to be the causative agents of human trichinellosis, a disease that not only is a public health hazard by affecting human patients but also represents an economic problem in porcine animal production and food safety. Due to the predominantly zoonotic importance of infection, the main efforts in many countries have focused on the control of Trichinella or the elimination of Trichinella from the food chain. The most important source of human infection worldwide is the domestic pig, but, e.g., in Europe, meats of horses and wild boars have played a significant role during outbreaks within the past 3 decades. Infection of humans occurs with the ingestion of Trichinella larvae that are encysted in muscle tissue of domestic or wild animal meat. Early clinical diagnosis of trichinellosis is rather difficult because pathognomonic signs or symptoms are lacking. Subsequent chronic forms of the disease are not easy to diagnose, irrespective of parameters including clinical findings, laboratory findings (nonspecific laboratory parameters such as eosinophilia, muscle enzymes, and serology), and epidemiological investigations. New regulations laying down rules for official controls for Trichinella in meat in order to improve food safety for consumers have recently been released in Europe. The evidence that the disease can be monitored and to some extent controlled with a rigorous reporting and testing system in place should be motivation to expand appropriate programs worldwide.

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“…Vuitton (2009) concluded that 'benzimidazoles have deeply modified the management of cystic echinococcosis patients and life expectancy of alveolar echinococcosis patients. ' Due to the activities and endurance of Rudolf Ammann (1926e2015), Professor of Gastroenterology at the University Hospital Z€ urich, and a group of colleagues and coworkers (see list of references), a large group of AE patients under treatment and medical care was observed in Switzerland over more than three decades (Ammann et al, 1999(Ammann et al, , 2004Kadry et al, 2005;Torgerson et al, 2008). A sign of R. Ammann's tireless passion for echinococcosis research is that the results of his last long-term study were published 3 months before his death (Ammann et al, 2015).…”

Section: Chemotherapymentioning

confidence: 99%

Historical Aspects of Echinococcosis

Eckert

Thompson

2017

Advances in Parasitology

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Evaluation of treatment and long-term follow-up in patients with hepatic alveolar echinococcosis

Abstract: Debulking hepatic resections do not appear to offer any advantage in the treatment of patients with alveolar echinococcosis.

Cited by 99 publications

References 21 publications

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Epidemiology, Diagnosis, Treatment, and Control of Trichinellosis

Historical Aspects of Echinococcosis

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