Percutaneous ultrasound intervention therapy for hepatic echinococcosis: a literature review_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHENG Siyuan , LIU Xiaoshen ,  REN Li

Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Qinghai University, Xining 810001, P. R. China;

Corresponding author：

REN Li, Email: renLi@163.com

Keywords：

hepatic echinococcosis; liver hydatid disease; ultrasound; interventional therapy; review

DOI：

10.7507/1007-9424.202408081

Video：

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Objective To summarize the research status of percutaneous ultrasound interventional therapy for the patients with hepatic echinococcosis, and to provide some experience and reference for the treatment of disease in clinical medical personnel. Method The relevant literature on percutaneous ultrasound intervention therapy for hepatic echinococcosis both domestically and internationally was summarized and analyzed. Results For the patients with hepatic cystic echinococcosis (HCE), ultrasound-guided percutaneous transhepatic drainage is safe and effective for the World Health Organization Informal Working Group classification CE1 and CE3a cysts. For the patients with hepatic alveolar chinococcosis (HAE), although radical resection is still the gold standard, ultrasound-guided microwave ablation had better postoperative recovery and less trauma for patients with lesion diameter ＜5 cm; Due to limited research on the efficacy and safety of ultrasound-guided radiofrequency ablation for patients with HAE, further exploration is needed; Ultrasound guided percutaneous cyst puncture drainage is used for external drainage of necrotic material in the cyst cavity, which can effectively control infection and remove necrotic tissue; percutaneous transhepatic cholangial drainage (PTCD) could effectively relieve biliary obstruction, improve liver function, and enhance the quality of life of patients with advanced HAE complicated with obstructive jaundice. Conclusions Ultrasound-guided percutaneous interventional techniques have their own advantages and disadvantages in treatment of hepatic echinococcosis. For patients with HCE, strict indications and contraindications should be followed when performing percutaneous ultrasound interventions. For patients with HAE, early-stage small lesions should be prioritized for microwave ablation, and patients in the middle and late stages with larger lesions or those with intra-cyst infection or jaundice should be treated with percutaneous cyst puncture drainage and PTCD to alleviate symptoms, following the second stage operation.

Citation： ZHENG Siyuan, LIU Xiaoshen, REN Li. Percutaneous ultrasound intervention therapy for hepatic echinococcosis: a literature review. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(10): 1221-1227. doi: 10.7507/1007-9424.202408081 Copy

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2. Govindasamy A, Bhattarai PR, John J. Liver cystic echinococcosis: a parasitic review. Ther Adv Infect Dis, 2023, 10: 20499361231171478. doi: 10.1177/20499361231171478.
3. WHO Informal Working Group. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Trop, 2003, 85(2): 253-261.
4. Ferrer Inaebnit E, Molina Romero FX, Segura Sampedro JJ, et al. A review of the diagnosis and management of liver hydatid cyst. Rev Esp Enferm Dig, 2022, 114(1): 35-41.
5. Kahriman G, Ozcan N, Dogan S, et al. Percutaneous treatment of liver hydatid cysts in 190 patients: a retrospective study. Acta Radiol, 2017, 58(6): 676-684.
6. Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: Advances in the 21st century. Clin Microbiol Rev, 2019, 32(2): e00075-18. doi: 10.1128/CMR.00075-18.
7. Trigui A, Fendri S, Saumtally MS, et al. Standardized approach to the conservative surgery of hepatic cystic echinococcosis: A prospective study. PLoS Negl Trop Dis, 2024, 18(6): e0012289. doi: 10.1371/journal.pntd.0012289.
8. 王校智, 邵翔龙, 梁同治, 等. 肝腹腔包虫囊肿B超引导穿刺治疗初探. 中国超声医学杂志, 1991, 7(1): 57-58.
9. 曾静, 叶建蔚, 张静, 等. 肝囊型包虫病非手术治疗方法的研究进展. 现代生物医学进展, 2018, 18(19): 3790-3794.
10. Schiller CF. Complications of echinococcus cyst rupture. A study of 30 cases. JAMA, 1966, 195(3): 220-222.
11. Mottaghian H, Saidi F. Postoperative recurrence of hydatid disease. Br J Surg, 1978, 65(4): 237-242.
12. Mueller PR. Hepatic echinococcal cyst: successful percutaneous drainage. Radiology, 1985, 155: 627‐628.
13. Ben Amor N, Gargouri M, Gharbi HA, et al. Treatment of hepatic hydatid cyst in sheep by echographic puncture. Tunis Med, 1986, 64: 325-331.
14. Gargouri M, Ben Amor N, Ben Chehida F, et al. Percutaneous treatment of hydatid cysts ( Echinococcus granulosus ). Cardiovasc Intervent Radiol, 1990, 13: 169-173.
15. Giorgio A, Tarantino L, de Stefano G, et al. Percutaneous therapy of hydatid cyst of the liver with ultrasound-guided double puncture-aspiration and alcoholization. Radiol Med, 1991, 82(4): 460-464.
16. 王校智, 冯胜利. 包虫病经皮穿刺治疗的历史与现状. 青海医药杂志, 1994, (2): 61-64.
17. Dwivedi M, Misra SP, Dwivedi S, et al. Percutaneous treatment of hepatic hydatid cysts using hypertonic saline. J Assoc Physicians India, 2002, 50(5): 647-650.
18. Duţă C, Păscuţ M, Bordoş D. Percutaneous treatment of the liver hydatid cysts under sonographic guidance. Chirurgia (Bucur), 2002, 97(2): 173-177.
19. Smego RA, Bhatti S, Khaliq AA, et al. Percutaneous aspiration-injection-reaspiration drainage plus albendazole or mebendazole for hepatic cystic echinococcosis: a meta-analysis. Clin Infect Dis, 2003, 37(8): 1073-1083.
20. Brunetti E, Kern P, Vuitton DA, et al. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop, 2010, 114(1): 1-16.
21. Duta C, Pantea S, Lazar C, et al. Minimally invasive treatment of liver hydatidosis. JSLS, 2016, 20(1): e2016.00002. doi: 10.4293/JSLS.2016.00002.
22. Sokouti M, Sadeghi R, Pashazadeh S, et al. A systematic review and meta-analysis on the treatment of liver hydatid cyst using meta-MUMS tool: comparing PAIR and laparoscopic procedures. Arch Med Sci, 2019, 15(2): 284-308.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Percutaneous ultrasound intervention therapy for hepatic echinococcosis: a literature review

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