DOI: http://dx.doi.org/10.18203/2349-2902.isj20184715

Surgical treatment of Abdominal Echinococcosis

Anuroop Thota, A. Dinakar Reddy, Venkata Narasimha Rao V.

Abstract


Background: Cystic Echinococcosis is a zoonosis with worldwide geographical distribution caused by dog tapeworm. Cystic echinococcosis most frequently involves only one organ by forming a solitary cyst. Hydatid disease commonly involves the liver (75%) and lungs (15%), followed by other regions of the body (10-15%). Multi-organ abdominal HD is the most serious form and is potentially fatal.

Methods: It is a retrospective study for a duration of 3 years. The recorded data of all the patients undergoing treatment has been collected and analyzed.

Results: A total of 30 patients were identified. Most common organ involved was liver followed by spleen, pancreas and kidney. Cysts are more commonly seen in right lobe. All the patients underwent surgical treatment. 17 patients underwent open surgery, while 13 patients were treated by laparoscopy. Cysto biliary communication was identified in 3 patients, all in laparoscopy and a primary closure was done. All the patients were started on albendazole 400 mg twice daily per oral at least 15 days prior to surgery and this treatment was continued for 3 months post-operatively.

Conclusions: Hydatid disease is endemic in sheep farming and cattle farming areas of Asia. Most patients remain asymptomatic for years. Diagnosis is by imaging techniques. Echinococcal infection usually requires multimodality treatment and the best treatment is always individualized. Surgery along with anti-helminthic treatment holds the best curative measure at present.


Keywords


Cystic echinoccocosis, Echinococcosis, Hydatid disease, Pericystectomy, Zoonosis

Full Text:

PDF

References


McManus DP, Zhang W, Li J, Bartley PB. Echinococcosis. Lancet. 2003;362:1295-304.

Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Tropica. 2010;114:1-16.

Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of Echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev. 2004;17:107-35.

Zheng X, Zou Y, Yin C. Rare presentation of multi-organ abdominal echinococcosis: report of a case and review of literature. Int J Clin Exp Pathol. 2015;8(9):11814-8.

Mergen H, Genç H, Tavusbay C. Assessment of liver hydatid cyst casese 10 years’ experience in Turkey. Trop Doct. 2007;37(1):54e6.

Malik AA, ul Bari S, Younis M, Wani KA, Rather AA. Primary splenic hydatidosis. Indian J Gastroenterol. 2011;30:175-7.

Masoodi I, Nabi G, Kumar R, Lone MA, Khan BA, Naseer Al Sayari K. Hydatid cyst of pancreas: a case report and brief review. Turk J Gstroenterol. 2011;22:430-2.

Ousadden A, Elbouhaddouti H, Ibnmajdoub KH, Mazaz K, Aittaleb K. Primary Hydatid cyst of pancreas with a hepatic pedicule compression. Cases J. 2009;2:201.

Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects of Echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev. 2004;17:107-35.

Thomas S, Mishra MC, Kriplani AK, Kapur BM. Hydatidemesis: a bizarre presentation of abdominal hydatidose. Aust N Z J Surg. 1993;63:496-8.

Stamatakos M, Kontzoglou K, Tsaknaki S, Sargeti C, Iannescu R, Safioleas C, et al. Intrahepatic bile duct rupture of hydatid cyst: a severe complication for the patient. Chirurgia (Bucur). 2007;102:257-62.

WHO Informal Working Group. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings. Acta Tropica. 2003;85(2):253-61.

Kalovidouris A, Gouliamos A, Vlahos L. MRI of abdominal hydatid disease. Abdom Imaging. 1994;19:48994.

Patkowski W, Krasnodębski M, Grąt M, Masior L, Krawczyk M. Surgical treatment of hepatic Echinococcus granulosus. Gastroenterolo Rev. 2017;12(3):199-202.

Junghanss T, da Silva AM, Horton J, Chiodini PL, Brunetti E. Clinical management of cystic echinococcosis: state of the art, problems, and perspectives. Am J Trop Med Hyg. 2008;79:301-11.

Gupta N, Javed A, Puri S, Jain S, Singh S, Agarwal AK. Hepatic hydatid: PAIR, drain or resect? J Gastrointest Surg. 2011;15:1829-36.

Saidi F. Surgery of hydatid disease. Philadelphia: Saunders; 1976.

Georgiou GK, Lianos GD, Lazaros A. Surgical management of hydatid liver disease. Int J Surg 2015;20:118-22.

Zaharie F, Bartos D, Mocan L, Zaharie R, Iancu C, Tomus C. Open or laparoscopic treatment for hydatid disease of the liver? A 10-year single-institution experience. Surg Endosc. 2013;27:2110-6.

Acarli K. Controversies in the laparoscopic treatment of hepatic hydatidosis. HPB. 2004;6(4):213-21.