Percutaneous treatment of hepatic cystic echinococcosis: the success of alcohol as a single endocavitary agent in PAIR, catheterization, and modified catheterization techniques

• Published in: Radiologia medica 2018-02, Vol.123 (2), p.153-160
• Main Authors: Bakdik, Suleyman, Arslan, Serdar, Oncu, Fatih, Tolu, Ismet, Eryilmaz, Mehmet Ali
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alcohol; Catheterization; Catheterization - methods; Child; Child, Preschool; Cysts; Diagnostic Radiology; Echinococcosis, Hepatic - classification; Echinococcosis, Hepatic - diagnosis; Echinococcosis, Hepatic - parasitology; Echinococcosis, Hepatic - therapy; Ethanol - administration & dosage; Female; Follow-Up Studies; Humans; Imaging; Interventional Radiology; Intubation; Lesions; Liver; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Patients; Percutaneous treatment; Radiology; Retrospective Studies; Sclerosing Solutions - administration & dosage; Success; Suction; Treatment Outcome; Ultrasonography, Interventional - methods; Ultrasound; Vascular and Interventional Radiology
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-017-0820-0

Objectives This retrospective study aims at demonstrating the success rate, effectiveness, and advantages of alcohol as a scolicidal and sclerosing agent for the percutaneous treatment of liver hydatid cysts. Methods A total of 554 liver hydatid cysts obtained from 347 patients admitted between January 2008 and February 2016 were retrospectively investigated. Of these, 435 (78.5%), 91 (16.4%), and 28 (5%) were classified as Gharbi type 1, 2, and 3, respectively. Type 1 and 2 cysts were treated using PAIR (puncture, aspiration, injection, respiration) and single puncture catheterization methods; type 3 lesions were treated using a modified catheterization technique. Alcohol was used as a scolicidal and sclerosing agent in all procedures. Results After excluding three lesions (0.5%) because of lack of parenchymal support during catheterization, 274 (49.7%), 250 (45.3%), and 27 (4.9%) of 551 lesions were treated with PAIR, single puncture catheterization, and modified catheterization techniques, respectively. Therefore, a 99.5% of technical success rate was obtained. Major complications in 2 patients (0.5%) and minor complications were observed in 36 patients (10.3%). Mean hospital stay was 1.55±2.3 days (range: 0-23 days). Patients were followed-up for mean 19.6 months (range: 6-83 months), during which recurrences were detected in 19 patients (5.4%). Conclusions The use of alcohol as a scolicidal and sclerosing agent during the percutaneous treatment of liver hydatid cysts is associated with a high success rate and low rates of recurrence and complications, and should be considered an important alternative to surgical procedures.