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Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 2002 Mar;84(2):100–105.

A combined medical and surgical approach to hydatid disease: 12 years' experience at the Hospital for Tropical Diseases, London.

H M Ayles 1, E L Corbett 1, I Taylor 1, A G A Cowie 1, J Bligh 1, K Walmsley 1, A D M Bryceson 1
PMCID: PMC2503771  PMID: 11995745

Abstract

BACKGROUND: There is no consensus as to the most appropriate treatment for the varied and often complicated presentations of hydatid disease in Britain. We looked at our own results over a 12-year period to see if a consistent and logical plan had emerged. PATIENTS AND METHODS: 70 patients presenting between 1986 and 1998 were analysed retrospectively, with regard to their presentation, diagnosis, treatment and outcome, with particular reference to the use of chemotherapy, and to the difficulties of post-treatment assessment by serology and imaging. RESULTS: 37 patients had been treated previously. 35 had hepatic cysts and 26 multiple cysts. 4 patients were treated by surgery alone, 44 by chemotherapy and surgery, and 14 by chemotherapy alone. The combined use of albendazole and praziquantel pre-operatively reduced significantly the number of cysts that contained viable protoscolices: 1/25 versus 5/8 that received albendazole alone (P = 0.00013). During the 12-year period, it became our policy to aim for 3 months drug treatment (albendazole throughout with praziquantel for 2 weeks), re-assess and proceed either to surgery or to continue with chemotherapy. CONCLUSIONS: It is possible to construct an algorithm for the management of patients with hydatid disease by chemotherapy and surgery, but the assessment of results by indirect techniques remains difficult.

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Selected References

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  1. Babba H., Messedi A., Masmoudi S., Zribi M., Grillot R., Ambriose-Thomas P., Beyrouti I., Sahnoun Y. Diagnosis of human hydatidosis: comparison between imagery and six serologic techniques. Am J Trop Med Hyg. 1994 Jan;50(1):64–68. doi: 10.4269/ajtmh.1994.50.64. [DOI] [PubMed] [Google Scholar]
  2. Chapoy P., Giraud J. P., Quilici M. Albendazole: does it increase the risk of rupture for hydatid cyst of the liver? Gastroenterol Clin Biol. 1985 Feb;9(2):187–188. [PubMed] [Google Scholar]
  3. Fenton-Lee D., Morris D. L. The management of hydatid disease of the liver: Part 2. Trop Doct. 1997 Apr;27(2):87–88. doi: 10.1177/004947559702700213. [DOI] [PubMed] [Google Scholar]
  4. Gil-Grande L. A., Rodriguez-Caabeiro F., Prieto J. G., Sánchez-Ruano J. J., Brasa C., Aguilar L., García-Hoz F., Casado N., Bárcena R., Alvarez A. I. Randomised controlled trial of efficacy of albendazole in intra-abdominal hydatid disease. Lancet. 1993 Nov 20;342(8882):1269–1272. doi: 10.1016/0140-6736(93)92361-v. [DOI] [PubMed] [Google Scholar]
  5. Horton R. J. Albendazole in treatment of human cystic echinococcosis: 12 years of experience. Acta Trop. 1997 Apr 1;64(1-2):79–93. doi: 10.1016/s0001-706x(96)00640-7. [DOI] [PubMed] [Google Scholar]
  6. Khoury G., Jabbour-Khoury S., Bikhazi K. Results of laparoscopic treatment of hydatid cysts of the liver. Surg Endosc. 1996 Jan;10(1):57–59. doi: 10.1007/s004649910014. [DOI] [PubMed] [Google Scholar]
  7. Khuroo M. S., Dar M. Y., Yattoo G. N., Zargar S. A., Javaid G., Khan B. A., Boda M. I. Percutaneous drainage versus albendazole therapy in hepatic hydatidosis: a prospective, randomized study. Gastroenterology. 1993 May;104(5):1452–1459. doi: 10.1016/0016-5085(93)90355-g. [DOI] [PubMed] [Google Scholar]
  8. Khuroo M. S., Wani N. A., Javid G., Khan B. A., Yattoo G. N., Shah A. H., Jeelani S. G. Percutaneous drainage compared with surgery for hepatic hydatid cysts. N Engl J Med. 1997 Sep 25;337(13):881–887. doi: 10.1056/NEJM199709253371303. [DOI] [PubMed] [Google Scholar]
  9. Magistrelli P., Masetti R., Coppola R., Messia A., Nuzzo G., Picciocchi A. Surgical treatment of hydatid disease of the liver. A 20-year experience. Arch Surg. 1991 Apr;126(4):518–523. doi: 10.1001/archsurg.1991.01410280122020. [DOI] [PubMed] [Google Scholar]
  10. Matossian R. M., McLaren M. L., Draper C. C., Bradstreet C. M., Dighero M. W., Kane G. J., Mackinlay L. M., Rickard M. D. The serodiagnosis of human hydatid disease: 2. Additional studies on selected sera using indirect haemagglutination (IHA), enzyme linked immunosorbent assay (ELISA) and defined antigen substrate spheres (DASS). J Helminthol. 1979 Dec;53(4):287–291. doi: 10.1017/s0022149x0000612x. [DOI] [PubMed] [Google Scholar]
  11. Moreno González E., Jover navalón J. M., Landa García J. I., Moreno Azcoíta M., Silecchia G., Gómez Gutiérrez M., Arias Díaz J. Surgical management of liver hydatidosis. 10-year experience with 269 patients. Ital J Surg Sci. 1985;15(3):267–273. [PubMed] [Google Scholar]
  12. Moreno González E., Rico Selas P., Martínez B., García García I., Palma Carazo F., Hidalgo Pascual M. Results of surgical treatment of hepatic hydatidosis: current therapeutic modifications. World J Surg. 1991 Mar-Apr;15(2):254–263. doi: 10.1007/BF01659061. [DOI] [PubMed] [Google Scholar]
  13. Morris D. L., Chinnery J. B., Georgiou G., Stamatakis G., Golematis B. Penetration of albendazole sulphoxide into hydatid cysts. Gut. 1987 Jan;28(1):75–80. doi: 10.1136/gut.28.1.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morris D. L., Richards K. S., Chinnery J. B. Protoscolicidal effect of praziquantel--in-vitro and electron microscopical studies on Echinococcus granulosus. J Antimicrob Chemother. 1986 Dec;18(6):687–691. doi: 10.1093/jac/18.6.687. [DOI] [PubMed] [Google Scholar]
  15. Morris D. L., Taylor D., Daniels D., Richards K. S. Determination of minimum effective concentration of praziquantel in in vitro cultures of protoscoleces of Echinococcus granulosus. Trans R Soc Trop Med Hyg. 1987;81(3):494–497. doi: 10.1016/0035-9203(87)90173-8. [DOI] [PubMed] [Google Scholar]
  16. Moskopp D., Lotterer E. Concentrations of albendazole in serum, cerebrospinal fluid and hydatidous brain cyst. Neurosurg Rev. 1993;16(1):35–37. doi: 10.1007/BF00308610. [DOI] [PubMed] [Google Scholar]
  17. Parija S. C. New approaches in the serodiagnosis of hydatid disease. J Indian Med Assoc. 1994 Sep;92(9):281-2, 284. [PubMed] [Google Scholar]
  18. Richards K. S., Morris D. L. Effect of albendazole on human hydatid cysts: an ultrastructural study. HPB Surg. 1990 Apr;2(2):105–113. doi: 10.1155/1990/47243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Richards K. S., Riley E. M., Taylor D. H., Morris D. L. Studies on the effect of short term, high dose praziquantel treatment against protoscoleces of ovine and equine Echinococcus granulosus within the cyst, and in vitro. Trop Med Parasitol. 1988 Dec;39(4):269–272. [PubMed] [Google Scholar]
  20. Taylor D. H., Morris D. L. Combination chemotherapy is more effective in postspillage prophylaxis for hydatid disease than either albendazole or praziquantel alone. Br J Surg. 1989 Sep;76(9):954–954. doi: 10.1002/bjs.1800760927. [DOI] [PubMed] [Google Scholar]
  21. Taylor D. H., Morris D. L., Richards K. S. Echinococcus granulosus: in vitro maintenance of whole cysts and the assessment of the effects of albendazole sulphoxide and praziquantel on the germinal layer. Trans R Soc Trop Med Hyg. 1989 Jul-Aug;83(4):535–538. doi: 10.1016/0035-9203(89)90282-4. [DOI] [PubMed] [Google Scholar]
  22. Todorov T., Mechkov G., Vutova K., Georgiev P., Lazarova I., Tonchev Z., Nedelkov G. Factors influencing the response to chemotherapy in human cystic echinococcosis. Bull World Health Organ. 1992;70(3):347–358. [PMC free article] [PubMed] [Google Scholar]
  23. Yasawy M. I., al Karawi M. A., Mohamed A. R. Combination of praziquantel and albendazole in the treatment of hydatid disease. Trop Med Parasitol. 1993 Sep;44(3):192–194. [PubMed] [Google Scholar]

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