Percutaneous treatment of hydatid liver cysts in children as a primary treatment: long-term results.

摘要

PURPOSE: To evaluate the effectiveness and long-term results of percutaneous treatment for hydatid liver cysts in pediatric patients. MATERIALS AND METHODS: Thirty-four pediatric patients (15 male, 19 female; ages 4-17 years; mean age, 9.4 years) with 51 hydatid liver cysts underwent ultrasound (US)-guided percutaneous treatment with albendazole prophylaxis. There were 15 type II lesions with membrane detachment and 36 type I lesions resembling simple hepatic cysts with pure anechogenic content or small echogenic reflections and a regular well-delineated wall. The method of US-guided puncture, aspiration, injection of hypertonic saline solution, and reaspiration was preferred for 21 lesions. For the remaining 30 larger cysts, the intervention was performed with the same percutaneous technique but followed by catheterization, drainage, control cystography, and sclerotherapy with ethanol. During follow-up, US examinations were performed at 1, 3, 6, and 12 months for the first year and yearly thereafter. RESULTS: Percutaneous treatment of hepatic hydatid disease was successful in 33 patients (97.1%). During follow-up, US findings in the lesions changed significantly; at year 1, the inner content of the lesions became heterogeneous with a semisolid appearance, and the mean reduction in volume was 81.4%. At 2-year follow-up, most hydatid cysts had become solid in nature and the reduction in volume reached 65%-99% (mean, 85.1%). There were no recurrences or additional lesions after the follow-up of 1-6 years (mean, 3.1 years). Average hospital stay for the whole group in this study was 3.5 days. CONCLUSIONS: The long-term results of percutaneous liver hydatid cyst treatment in children are in accordance with the results in adults. Percutaneous treatment of uncomplicated type I and type II liver hydatid cysts in pediatric patients is an efficient and safe treatment with short hospitalization.