Management of Cystic Echinococcosis Complications and Dissemination: Where is the Evidence?

摘要: This systematic review was designed to provide “evidence-based” answers identify the best treatment for a complicated hydatid cyst of liver and appropriate management disseminated cystic echinococcosis. An extensive electronic search relevant literature performed using Medline Cochrane Library. enabled us make determine options following conditions. Liver cysts ruptured into biliary tract: Common bile duct exploration should be conducted intraoperative cholangiography choledoscopy. When tract is cleared all content, T-tube drainage sufficient. The principal difficulty concerned large biliocystic fistula: suture or internal transfistulary fistulization. Medical indicated in association with surgery 3 months postoperatively. During preoperative period, endoscopic retrograde cholangiopancreatography (ERCP) combined sphincterotomy (ES) may decrease incidence postoperative external fistula. involving thorax: abdominal approach mandatory when common required, it sufficient treat direct rupture bronchi. acute abdomen, owing peritoneum, requires an emergent operation. associated. Cystic echinococcosis lung: Surgery still main therapeutic option remove cyst, bronchial fistula if necessary, followed by capitonnage. Osseous echinococcosis: Wide surgical excision recommended. heart: Cystopericystectomy “gold standard” procedure but sometimes unsuitable particular sites. kidney: Cystectomy pericystectomy feasible 75% cases; nephrectomy must reserved destroyed kidney. Multiple associated locations: Complicated treated high priority. In case several liver, spleen, removal same intervention there no threat life patient. Otherwise, planned reoperation considered.