Percutaneous Treatment of Giant Cystic Echinococcosis in Liver: Catheterization Technique in Patients with CE1 and CE3a

Abstract

Purpose: This study aimed to evaluate the efficacy, safety, and follow-up results of the percutaneous treatment of cystic echinococcosis (CE) patients with giant hepatic cysts (at least one diameter > 10 cm).

Methods: Between January 2013 and 2018, 31 CE patients with 34 giant cysts classified as CE1 or CE3a (Gharbi type 1 or 2) according to the World Health Organization criteria and treated with the catheterization technique were analyzed retrospectively.

Results: Thirty-four giant hepatic cysts were treated using the catheterization technique. Technical success was 100%. One procedure was sufficient for 27 of these cysts, while six patients underwent a second procedure due to recurrence, recollection or complications; one did not accept a repeat procedure and decided to refer to surgery due to pain. Ten (29%) major complications developed. The overall clinical success was 97%. The mean follow-up period was 20 months (5-61 months), and the total reduction in the cyst volume was 92%.

Conclusion: The catheterization technique is effective in treating giant CE with acceptable complication rates.

Level of evidence: Level 4, Clinical Investigation.

Keywords: Abscess; Catheterization technique; Cavity infection; Coil embolization; Cystobiliary fistula; Fistula embolization; Giant cystic echinococcosis; Giant hydatid cyst; Glue embolization; Percutaneous techniques.