Liver hydatidosis in the present decade

Abstract

Liver hydatidosis, a parasitic endemic disease affecting extensive areas in our planet, has been for decades a topic of debate in multiple medical and surgical forums because of its incidence, nonspecific symptoms, and diagnostic modalities, as well as the surgical procedures devised to solve this condition.On the other hand the relevant complications that may arise with disease progression and may involve multiple organs and neighboring structures causing disruption, migration, contamination, etc., turned this disease into a significant stigma within medicine, enrolling healthcare providers (veterinarians, internists, radiologists, surgeons, etc.) who for decades attempted to reduce its incidence, find better diagnostic modalities, control its spreading, and provide new therapies in order to achieve a more optimistic view of the problem.In our country, endemic areas existed for many years where incidence and prevalence rates were high, which was reported in a 1987 publication including over 7000 surgically-treated liver hydatidosis cases, the largest series reported in the medical literature worldwide to that day (1).New diagnostic procedures (ultrasounds, scanners), new anti-parasitic therapies (albendazole), and novel surgical procedures (PAIR, radical surgery) emerged over the years, which have clarified and significantly improved long-term results (2,3).In the first report (1) of surgical treatment data, conservative surgery (marsupialization, lay-open, partial cystectomy, etc.) represented 65% of cases, and was associated with high morbidity. Mortality (2.3%) was similar for both radical and conservative surgery.Several years later, in a smaller series of patients by Servicio Nacional de Salud hospitals, radical surgery was 72.7% and conservative procedures had boiled down to 28%. Mortality for conservative surgery persisted around 2% and was nil for radical surgery (4).In the last few years hydatidosis has considerably changes in many respects, from diagnostic strategies to treatment approaches (2,3), not forgetting new presentation forms and complications. The development of clinical therapy guidelines (5) and of evidence-based medicine (6) has spread among the medical community concepts that we all should bear in mind when suggesting an elective therapy for this condition.New diagnostic modalities (ultrasonography, 3D scanner, MRI, ability to assess liver function, etc.) have led to new considerations and added accuracy to both cyst and liver functional assessment, providing new ideas for effective treatment. In this respect, this same issue of our Journal includes a retrospective study assessing the possibility of leaving selected (asymptomatic) liver cysts untreated with only followup (7). As it is a retrospective, observational review, its scientific value is hardly relevant given its limitations and small number of patients; however, it represents an interesting viewpoint to be considered in a near future. Liver hydatidosis in the present decade61130-0108/2011/103/9/445-447 REVISTA ESPAÑOLA DE ENF...

Laparoscopic Approach to Liver Hydatidosis: Initial Experience

“…It also has the added benefit of being used without restrictions for aspiration, which is so important for the treatment of this disease. 13,14 It was not necessary to convert to open surgery in any of the cases, which coincides with the publications of other authors. 5,9,10 Mean hospital stay was 52 h. This also coincides with other authors, 9,12 although some reported a mean of 2 days.…”

Gallbladder leiomyoma in absence of immune system disorders: an unusual diagnosis

“…Abdominal echography shows the formation of biliary mud and a heterogeneous, hyperechoic mass of 45 mm adjacent to the gallbladder compatible with a diagnosis of hydatic cyst. Although the patient cohabits with dogs in an endemic area of hydatosis as is Spain (1,2), and the initial diagnosis leads to such condition, serology for hydatosis is negative. Abdominal CT scan (Fig.…”