Results of treatment of 31
hepatic hydatid cysts in 28 patients were analyzed. The size of the s ranged from 3 to 25 cm. In 26 cases the
cysts contained flive es, in 2 cases they were suppurated after US-assisted intraoperative
puncture. Simple
hydatid cysts (type I by M. Milcevic) were diagnosed in 24 patients (solitary--in 22, multiple--in 2),
solitary cysts of type II--in 2 patients. In 23 cases aspiration-
catheter treatment with complete removal of
chitin membrane by one-stage (4) or two-stage (19) methods was performed. After removal of
chitin membrane in 3 patients lateral
fistula between spurious
cysts cavities and peripheral branches of intrahepatic bile ducts were revealed which spontaneously. Glue composition "Rabrom" was used in 2 cases for closure of the residual cavity. In 4 patients who had
cysts less 6 cm in size
puncture irrigation of
chitin cavity with 30% NaCl (PAIR technique) without it removal was performed. In one patient transcutaneous
catheter (PAIR-PD technique) was used for irrigation of the
cyst larger than 6 cm. The duration of two-stage aspiration-
catheter treatment with removal of
chitin membrane was 25.6 +/- 9.6 days. In moderate
calcinosis of the fibrous membrane and bile
fistulas period of hospitalization was 34 +/- 8.1 days. Treatment with PAIR and PAIR-PD took 1 and 3 days respectively. Complications of percutaneous methods were regarded as mild:
hyperthermia (12), right-sided
hydrothorax (6), subcapsular
hematoma (1),
urticaria (1). All the complications were treated conservatively and with US-assisted
punctures. Long-term (from 6 months to 9 years) results of treatment were followed up in 26 patients: there were no recurrences.
Suppuration of the residual cavity 6 months after the glue occlusion was eradicated by transcutaneous
catheter drainage. One lethal outcome was not associated with complications of aspiration-
catheter treatment. Both methods of transcutaneous treatment of
hepatic hydatid cysts are effective and safe. A
hypertonic solution of NaCl I produces a reliable antiscolecidal and
sclerosis effect.