Percutaneous treatment of liver hydatid cysts

outcome of direct injection of albendazole under ultrasonographic guidance

Abstract

Objectives: To evaluate the efficiency of percutaneous aspiration and intracystic injection of albendazole in the treatment of liver hydatid cysts
under ultrasonographic guidance.
Patients and methods: A prospective study of
64 patients underwent percutaneous treatment
for 72 hydatid liver cysts under ultrasound guidance in Al-Thawrah & Al-Rayyan hospitals, Sana’a, & Mukalla respectively, Yemen. The PAI
(percutaneous aspiration and injection) method
was used. The cyst was punctured and most of
the cyst content was aspirated, then albendazole
solution was injected. Adjuvant oral albendazole
was used one week before and one month after
procedure. All patients underwent serial ultrasound follow up for three years and the therapeutic response was based on the sonographic
changes of the cyst and the serology titers.
Results: PAI was successfully performed for all
72 liver hydatid cysts with about 24 hours median hospital stay. All treated cysts showed collapse and detached endocyst immediately after
treatment, and re-expanded to almost its original
size during first week, then a progressive decrease in size was noted after the first month.
At the last follow up, the main reduction of
cyst volume was about 70% and the ultrasound
appearances were 63% solid form and 37%
of mixed solid and fluid form. Only two cysts
showed recurrence (of multivesicular type).Minor complications of the treatment were noted
included urticaria, fever, hypotension and slight
right pleural effusion.
Conclusion: PAI of albendazole is safe and
highly successful in the treatment of liver hydatid cysts especially univesicular type.