Hilar cholangiocarcinoma

Hilar cholangiocarcinoma(HC) is a rare tumor.It accounts for 2/3 of the tumors of the biliary tract.Untreated,prognosis is very poor.Surgery is the only therapy that offers the possibility of cure but is technically very complex.With recent improvements in the therapeutic strategies applied by multidisciplinary teams,survival rates in the different series currently range from 25% to 45%.A group of experts devoted to HC(pathologists,gastroenterologists,radiologists,surgeons and oncologists) have reviewed and updated every open question in HC in a special issue.

Hydatid cyst of the colon:A systematic review of the literature

BACKGROUND Primary hydatid disease in the colon is an extremely rare finding. We performed a systematic review of cases of hydatidosis of the colon published to date. AIM To systematic review the published papers about hydatidosis of the colon. METHODS Following PRISMA guidelines, we performed an unlimited search for articles on CH in the MEDLINE (PubMed), EMBASE, Cochrane, Latindex and Scielo databases, published in English, Spanish, French, German or Italian between January 1, 1960 and December 15, 2018. The search items were:(Colon) AND [(hydatidosis) OR (hydatid disease) OR (echinococcosis)]. RESULTS Nine case reports were found [five men, four women, median age 64.55 years (range: 21-81)]. The most frequent clinical manifestation was abdominal pain (8/9)(88.9%). In almost all cases several image studies were carried out, but abdominal computed tomography was the most used (66.7%). Five resections of the colon (62.5%) and three sutures of the fistula between cyst and colon (37.5%) were performed. Four patients did not present post-operative complications, but one died. Postoperative period was recorded for a mean period of 35 months. No recurrences were recorded. CONCLUSION The most frequent symptom was abdominal pain (evidence level 4). Computed tomography was the most frequently used diagnostic imaging technique (evidence level 4). Colectomy was the most appropriate treatment (evidence level 5). All the diagnostic and therapeutic options for hydatid cysts located in colon have a low level of evidence.

Hydatid cyst of the gallbaldder: A systematic review of the literature

AIM To evaluate all the references about primary gallbladder hidatidosis looking for best treatment evidence.METHODS Search:1966-2015 in MEDLINE,Cochrane Library,SciELO,and Tripdatabase.Key words: "gallabladder hydatid disease" and "gallbladder hydatid cyst".We found 124 papers in our searches but only 14 papers including 16 cases were about hydatid cyst of the gallbladder(GBHC).RESULTS Eight cases of GBHC were women and seven men.One not mentioned.Median age was 48.3 years.The most frequent clinical symptom was abdominal pain(94%) usually in the right upper quadrant.Ultrasound was performed in ten patients(62.5%) but in most cases a combination of several techniques was performed.The location of the cysts was intravesicular in five patients.Five patients presented GBHC and liver hydatid cysts.Two patients presented cholelithiasis and one choledocholithiasis.The most frequent surgical technique was cholecystectomy by laparotomy(81.25%).Simultaneous surgery of liver cysts was carried out in five cases.Eleven patients did not present postoperative complications,but one died.The mean hospital stay was seven days.No recurrence of GBHC was recorded.CONCLUSION In GBHC,the most frequent symptom is right hypocondrium pain(evidence level V).Best diagnostic methods are ultrasound and computed tomography(level V,grade D).Suggested treatment is open cholecystectomy and postoperative albendazole(level V,grade D) obtaining good clinical results and none relapses.