Non-surgical approach to treat hepatic hydatid cysts

A research team from Saudi Arabia determined the efficacy and success of percutaneous aspiration irrigation and re-aspiration (PAIR) in the management of hepatic hydatidosis. They found that PAIR using hypertonic saline is very effective and safe with proper precautions.

Concerning treatment, until recently the only definitive treatment for hydatid disease had been surgery. Different surgical techniques and procedures have been carried out and even in some cases, a liver transplant has been required. Advances in drug therapy has been influenced by the introduction of albendazole and accelerated by addition of praziquantel, but this requires a long period of treatment i.e. up to a year or more, and is not effective for everyone.

A research article to be published on February 7, 2011 in the World Journal of Gastroenterology addresses this question. In this study, the authors assessed the value of percutaneous drainage with adjuvant medical therapy in 26 patients with confirmed 32 hepatic hydatid cysts (HHC) over an average follow-up period of 10 years.

All 32 cysts showed evidence of immediate collapse after completion of the procedure, and before discharge from hospital, ultrasound examination showed fluid reaccumulation in all cysts. Serial follow-up showed a progressive decrease in the size and change in the appearance of cysts. To confirm the sterility of these cystic cavities, seven cysts were re-aspirated on average 3 mo after the procedure. Investigations revealed no viable scolices.

The study might provide some confirmation of the efficacy of a non-surgical approach to the treatment of liver hydatidosis.