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| 1 | Review of the treatment of liver hydatid cysts显示文摘A review was carried out in Medline,LILACS and the Cochrane Library.Our database search strategy included the following terms: 'hydatid cyst','liver','management','meta-analysis' and 'randomized controlled trial'.No language limits were used in the literature search.The latest electronic search date was the 7th of January 2014.Inclusion and exclusion criteria: all relevant studies on the assessment of therapeutic methods for hydatid cysts of the liver were considered for analysis.Information from editorials,letters to publishers,low quality review articles and studies done on animals were excluded from analysis.Additionally,well-structured abstracts from relevant articles were selected and accepted for analysis.Standardized forms were designed for data extraction; two investigators entered the data on patient demographics,methodology,recurrence of HC,mean cyst size and number of cysts per group.Four hundred and fourteen articles were identified using the previously described search strategy.After applying the inclusion and exclusion criteria detailed above,57 articles were selected for final analysis: one meta-analysis,9 randomized clinical trials,5 non-randomized comparative prospective studies,7 non-comparative prospective studies,and 34 retrospective studies(12 comparative and 22 noncomparative).Our results indicate that antihelminthic treatment alone is not the ideal treatment for liver hydatid cysts.More studies in the literature support the effectiveness of radical treatment compared with conservative treatment.Conservative surgery with omentoplasty is effective in preventing postoperative complications.A laparoscopic approach is safe in some situations.Percutaneous drainage with albendazole therapy is a safe and effective alternative treatment for hydatid cysts of the liver.Radical surgery with preand post-operative administration of albendazole is the best treatment option for liver hydatid cysts due to low recurrence and complication rates. | Concepción Gomez i Gavara Rafael López-Andújar Tatiana Belda Ibáez José M Ramia ngel ngel Moya Herraiz Francisco Orbis Castellanos Eugenia Pareja Ibars Fernando San Juan Rodríguez | 2015 | World Journal of Gastroenterology2015,21,1: | 8 |
| 2 | Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease显示文摘Most cases of hepatic hydatid disease exhibit uncomplicated clinical course and management.However,the diagnosis and management of complicated hepatic hydatid disease is a special issue.One of the most common and serious complications of hepatic hydatid disease is the rupture of the cyst into intrahepatic bile ducts.The clinical appearance of intrabiliary rupture can range from asymptomatic to jaundice,cholecystitis,cholangitis,liver abscess,pancreatitis and septicemia.Current treatments for major ruptures can result in high morbidity and mortality rates.Furthermore,ruptures that cannot be diagnosed preoperatively can induce complications such as biliary fistulae,biloma,cavitary infection and obstructive jaundice.In the past,these complications were diagnosed and treated by surgical methods.Currently,complications in both the pre- and postoperative periods are diagnosed and treated by non-invasive or minimally invasive methods.In clinical practice,endoscopic retrograde cholangiopancreatography(ERCP) is indicated for patients with preoperative frank intrabiliary rupture in which hydatid elements are clearly seen in the bile ducts,or for biliary adverse events after surgery,including persistent biliary fistulae and jaundice.However,controversy concerning routine preoperative ERCP and prophylactic endoscopic sphincterotomy in patients suspected of having minor cystobiliary communications still remains.In this article,the role of ERCP in the diagnosis and management of hepatic hydatid disease during the pre- and postoperative periods is reviewed. | Kemal Dolay Sami Akbulut | 2014 | World Journal of Gastroenterology2014,20,41: | 5 |
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