OUR EXPERIENCE IN THE TREATMENT OF RESIDUAL CAVITY OF THE LIVER CYSTIC ECHINOCOCCOSIS (CASE REPORT)

Abstract

Cystic echinococcosis (CE) caused by Echinococcus granulosus is a parasitic infection affecting various organs, with hepatic cystic echinococcosis being prevalent in up to 75% of CE cases. While more common in less developed nations, hepatic CE poses clinical management challenges globally. Treatment modalities encompass both medical and surgical interventions. Endocystectomy offers a conservative surgical approach to hepatic CE, avoiding extensive liver resection.
The management of residual cavities post-surgery involves a combination of medical therapy and surgical intervention. Albendazole serves as the primary medical treatment, administered pre- and post-operatively to reduce parasite viability. Surgical options include percutaneous techniques such as PAIR and surgical resection, aiming for complete cyst removal while preserving hepatic function. Management of cyst-biliary fistula is crucial to address biliary complications.
Long-term follow-up is essential to monitor treatment response and detect recurrence. Postoperative complications, including biliary leakage and residual cavity infections, require vigilant management. Symptomatic residual cavities can manifest with fever and jaundice due to infection or biliary communication.
A case presentation underscores the challenges in managing residual cavities post-hepatic cystic echinococcosis surgery. Percutaneous intrahepatic drainage, guided by imaging, followed by alcohol ablation, effectively controlled bile flow and promoted cavity healing.
In conclusion, percutaneous intrahepatic drainage remains a key strategy for managing residual echinococcal cavities, with alcohol ablation as adjunctive therapy to halt bile flow and expedite cavity resolution.