Percutaneous treatment of abdominal and retroperitoneal echinococcal cysts using ultrasonography

AIMS In recent year's percutaneous drainage has been used successfully to treat the hydatid cysts. We performed a controlled trial to present the successful appliance of this method in the treatment of abdominal and retroperitoneal hydatid diseases. METHODS In a prospective study, we have assigned 84 patients (51 women and 33 men, average age 45.7 +/- 16.7 with hydatidosis to treatment with percutaneous drainage. Of these, 72 patients had hepatic cysts, seven had renal hydatid cysts and five patients had hydatid cyst in the spleen. Albendasole (10 mg per kilogram of body weight per day for eight weeks) was administered to the patients. Serial assessments included clinical and biochemical examinations, ultrasonography and serologic tests of echinococcal-antibody titers. RESULTS The mean hospital stay was 5.8 (+/- 3.1) days. Over a mean follow-up period of 24 months, the mean cyst diameter decreased from 81.4 (+/- 32.6) mm to 11.8 (+/- 14.5) mm. After 24 months follow-up period 62 cysts (74 percent) disappeared. After an initial rise, the echinococcal-antibody titers fell progressively and at the last follow-up were negative (< 1:160) in 73 patients (87 percent). There were procedure related complications in 29 patients (four patients had abscessus, six hypotension, seven urticaria, ten fever and two strong abdominal pain in the first hour after intervention). CONCLUSIONS Percutaneous drainage, combined with albendasole therapy, is an effective and safe method for the treatment of the abdominal and retroperitoneal hydatid cysts and requires a shorter hospital stay then surgery treatment.