Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method

Schipper, H.G.; Laméris, Johan S.; Delden, Otto M. van; Rauws, Erik A.; Kager, Piet A.

doi:10.1136/gut.50.5.718

Cited by 99 publications

(45 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In recent years, interventional radiologists and gastroenterologists have begun to use the PAIR and percutaneous evacuation of cyst content techniques (11)(12)(13)(14). Nowadays, cysts are mostly being treated using the PAIR technique in combination with USG.…”

Section: Discussionmentioning

confidence: 99%

An Alternative Method for Percutaneous Treatment Of Hydatid Cysts: PAI Technique

Özdil

Keçe²,

Ünalp³

2016

TurkiyeParazitolDerg

View full text Add to dashboard Cite

Objective: Surgery is still the first choice in complicated cystic echinococcosis. However, percutaneous methods have performed increasingly in recent years. The Puncture, Aspiration, Injection, Reaspiration (PAIR) technique is mostly the preferred percutaneous method. The Puncture, Aspiration, Injection (PAI) technique is the new modified method, which is differentiated from PAIR technique by its applicability to all types of hydatid cysts (types 1-5) and unperforming of reaspiration. Methods: The 52 hydatid cysts were prospectively examined in the study. Thirty-four of them were Types I and II, 13 of them were Type III, and 5 of them were Types IV and V. The technique was performed using the 20 G Chiba needle under the guidance of ultrasonography. Maximum cyst contents were aspirated immediately after the puncture to reduce the intracystic pressure. After confirming that aspirated liquid does not contain bile and that cyst has no cystobiliary connection, 95% alcohol was injected into the cavity, safely. Reaspiration of alcohol was not performed. Results: The cyst sizes were reduced after PAI on ultrasonographic evaluations in all cases. The liquid component disappeared and the cyst got solid characteristic three months after the procedure. Conclusion: All hydatid cyst types can be treated safely and effectively with PAI technique without considering dimensions and whether. Keywords: Cyst hydatid, therapeutic, methods Received: 26.04.2015Accepted: 14.04.2016 ÖZ Amaç: Cerrahi komplike kistik ekinokokkoziste hala ilk seçenektir. Buna ragmen son yıllarda perkütan metodlar daha sık uygulanmaktadır. PAIR (Giriş, Aspirasyon, İnjeksiyon, Reaspirasyon) tekniği çok sık uygulanan bir metodtur. PAI tekniği (Giriş, aspirasyon, İnjeksiyon) reaspirasyonun yapılmadığı ve tüm kist tiplerine (tip1-5) uygulanabilen yeni bir metodtur.Yöntemler: Prospektif olarak 52 hidatik kist olgusu çalışmaya alındı. Bunlardan 34'ü tip I-II, 13 tanesi tip III, 5 tanesi de tip IV ve V idi. Teknik ultrasonografi eşliğinde 20 G chiba ignesi kullanılarak yapıldı. Kist içine girer girmez kist basıncını düşürmek için maksimum içerik aspire edildi. Aspire edilen sıvıda bilier bağlantıyı gösteren safra sızıntısı olmadığından emin olduktan sonra kist kavitesi içine % 95 alkol verildi. Reaspirasyon yapılmadı. Bulgular: Üç ay sonraki ultrasonografik değerlendirmede tüm vakalarda kist boyutu küçüldü. Kistin likit komponenti kayboldu ve solit karakter kazandı. Sonuç: İçerisinde kız vezikül, yoğun septasyon varlığı ve kist boyutuna bakılmaksızın tüm hidatik kistler PAI tekniği ile güvenli ve etkili bir şekilde tedavi edilebilir.

show abstract

Section: Discussionmentioning

confidence: 99%

An Alternative Method for Percutaneous Treatment Of Hydatid Cysts: PAI Technique

Özdil

Keçe²,

Ünalp³

2016

TurkiyeParazitolDerg

View full text Add to dashboard Cite

show abstract

“…Those cysts are treated by percutaneous evacuation (PEVAC) or modified catheterization technique (MoCaT) or dilatable multi-function trocar (DMFT). These techniques are based on evacuating whole cystic materials, both germinative and laminated membranes (47)(48)(49)(50). Even though these techniques are effective and safe in the treatment of cysts with a solid component and multivesiculated and multiple daughter cysts; catheter time (13.7 days-72.3 days), hospitalization time (mean 38 days) and morbidity (21%) are higher than the PAIR technique, but comparable to surgery.…”

Section: Percutaneous Treatmentsmentioning

confidence: 99%

PAIR vs Örmeci technique for the treatment of hydatid cyst

Örmeci

2014

Turk J Gastroenterol

View full text Add to dashboard Cite

Hydatid disease is caused by the larval stages of Echinococcus Granulosus. Most patients with hydatid disease have no symptoms, unless there is compression of vital organs such as the hepatic veins, portal vein, hepatic artery in the liver, bronchia in the lungs or the brain, resulting in life threatening complications like anaphylactic shock and sudden death. There are four treatment strategies for cystic echinococcosis (CE)-surgery, percutaneous methods, medical treatments and watch and wait strategies.Medical treatment with albendazol, mebendazole or prazyquentel may cure only 2/3 of patients with CE. More than 30% of patients will reoccur after stopping the treatment. Watch and wait strategy is followed for asymptomatic and small cysts or CE type IV and Type V cysts. Surgical treatments were the gold standard for treatment of CE until the last 30 years. Consequently, surgical methods decreased while percutaneous methods of treatment increased. Due to higher mortality, morbidity, recurrence rates, longer hospital stays and higher costs in comparison to percutaneous methods like PAIR and ÖRMECİ technique, surgical treatment must be limited for the complicated hydatid cyst. Both the PAIR and Örmeci techniques are safe and effective. However, the Örmeci technique offers a simpler, inexpensive method of treatment, with no mortality, lower morbidity, low recurrence rate, while being out patient based. It can be used as the first choice of treatment modality in patients with cysts type CE type one, CE type two, CE Type 3A and CE Type 3B. In this review, treatment modalities for CE, but mainly percutaneous treatment, will be discussed.

show abstract

“…This method can be performed under laparotomy, laparoscopy or percutaneous puncture, and is indicated in cysts type 2 and 3b) of the US classification. Percutaneous approach is called PEvac (Puncture and Evacuation) [45], but has also other designations, like MoCaT (Modified Catheterization Technique), technique developed by Akhan et al since 2002 [46]. These techniques are considered the gold standard once they are minimal invasive, less painful for the patient, have less complication rate, and they are also less expensive, with earlier discharge and activity resumption.…”

Section: Stagementioning

confidence: 99%

Cystic Echinococcosis in the Liver: Nomenclature and Surgical Procedures

Silva¹

2015

J Surg Surgical Res

View full text Add to dashboard Cite

Cystic Echinococcosis (CE) is a zoonotic infection caused by larval form of the parasite Echinococcus granulosus. The adult tapeworm inhabit the small intestine of some carnivores (called definitive or final hosts), and the larval phase, or "metacestode" develops in the herbivores (intermediate hosts). The presentation form of the larval phase is the development of cysts, called hydatid cysts. Although all of us know the vital cycle of the parasite and the different aspects of the disease, the designations around the parasite, its evolution and some therapeutic procedures is not uniform. In fact we frequently see the use of inappropriate terms, based on incorrect concepts. It would be useful to use the same nomenclature and it is absolutely necessary that the nomenclature is correct and universally accepted. So, it is pertinent to remember some important points related to the CE and, above all, to clarify some aspects concerning its nomenclature, in order to understand better the therapeutic options, particularly the different surgical approaches.Despite the cysts can be localized in any organ, liver localization is the most frequent (60-70%). The development of a hydatid cyst is slow and usually without specific clinical manifestations, so the diversity of clinical manifestations is related to the anatomical localization of the cyst, its dimension, and the antigens responsible for the systemic hypersensitivity, which can occur in sequence of cyst rupture, spontaneously or traumatic, resulting in secondary echinococcosis. The therapeutic approach has nowadays different possibilities, which will be referred in this manuscript.

show abstract

Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method

Cited by 99 publications

References 17 publications

An Alternative Method for Percutaneous Treatment Of Hydatid Cysts: PAI Technique

An Alternative Method for Percutaneous Treatment Of Hydatid Cysts: PAI Technique

PAIR vs Örmeci technique for the treatment of hydatid cyst

Cystic Echinococcosis in the Liver: Nomenclature and Surgical Procedures

Contact Info

Product

Resources

About