Percutaneous management in hepatic alveolar echinococcosis:A sum of single center experiences and a brief overview of the literature

BACKGROUND Hepatic alveolar echinococcosis(HAE)is a serious zoonotic infection that affects humans.It may have a tumor-like appearance at times.Percutaneous treatment of HAE patients is extremely relaxing for them.HAE is a significant human zoonotic infection caused by the fox tapeworm Echinococcus Multilocularis larvae.It possesses the characteristics of an invasive tumor-like lesion due to its infiltrative growth pattern and protracted incubation period.The disease is endemic over central Europe,Asia,and North America.AIM To characterize HAE patients who were treated percutaneously,their outcomes,and the major technical features of percutaneous treatment in HAE.METHODS Patients who were treated with percutaneous cyst drainage and/or percutaneous biliary drainage were included in the study.Uncorrected abnormal coagulation values and solid or non-infected HAE with minor necrotic change were excluded.RESULTS Thirty-two patients underwent percutaneous cyst drainage,two patients underwent percutaneous biliary drainage,and four patients underwent percutaneous biliary drainage alone.Interventional radiology is utilized to drain echinococcal necrosis and abscesses within/without the liver,as well as diseased and clogged bile ducts.CONCLUSION Percutaneous drainage of cyst contents and/or biliary channels using a minimally invasive technique is a very beneficial.Percutaneous cyst drainage with albendazole therapy improves quality of life in patients who are unable to undergo surgery,even when the mass resolves with long-term treatment.

Hepatic cystic echinococcosis:Percutaneous treatment as an outpatient procedure

Objective:To demonstrate utility and safety of the puncture aspiration injection and reospiration(PAIR)technique for outpatients.Methods:Percutaneous treatment with US guidance was applied to 33 patients for 44 cysts.Patients treated with the PAIR technique,were outpatients.PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates.Results:Thirty-five of 44 cysts were treated with the PAIR and 9 of 44 were treated with the catheterization technique.The success rate of the cysts Gharbi type 1(CEI)and type 2(Ct3a)treated with the PAIR technique was 1009.hi the follow up of 9 cysts treated with the catheterization technique,2 of them(22%)developed cyst infection and 1(11%)developed a biliary fistula.Conclusions:The PAIR technique was found to be an effective and safe approach in order to treat Gharbi type 1 and type 2 cysts percutaneously for outpatients.It has a very low complication rate in comparison with the catheterization technique.So every effort should be mode to finish the treatment with PAIR technique.

Effects of honey as a scolicidal agent on the hepatobiliary system

AIM： To examine the effects of 10% diluted honey, which has been shown to be scolicidal, on the liver and biliary system and determine whether it could be used as a scolicidal agent in the presence of biliary-cystic communication. METHODS： Thirty Wistar-Albino rats were divided into two groups. Honey with 10% dilution in the study group and 0.9% saline （NaCI） in the control group were injected into the common bile ducts of rats through a 3-mm duodenotomy. The animals were sacrificed 6 mo alter the procedure. Histopathological, biochemical, and radiological examinations were performed for evaluation of side effects. RESULTS： At the end of the sixth month, liver function tests were found to be normal in both groups. The tissue samples of liver and ductus choledochus of the honey group showed no histomorphologic difference from the control group. No stricture on the biliary tree was detected on the retrograde cholangiograms. CONCLUSION： According to these results, we concluded that 10% diluted honey could be used as scolicidal agent safely in the presence of biliary-cystic communication.