Surgical treatment of complicated hepatic echinococcosis in two Bulgarian citizens at two surgical departments in the Czech Republic


Authors: P. Vávra 1;  V. Třeška 2;  P. Ostruszka 1;  A. Sutnar 2;  J. Fichtl 2;  L. Hozáková 3;  M. Mitták 1;  J. Horáček 4
Authors‘ workplace: Chirurgická klinika FN Ostrava a LF Ostravské univerzity, přednosta Doc. MUDr. J. Dostalík, CSc. 1;  Chirurgická klinika FN Plzeň, přednosta: Prof. MUDr. V. Třeška, CSc. 2;  Klinika infekčního lékařství FN Ostrava, přednosta: MUDr. L. Rožnovský, CSc. 3;  Ústav patologie LF Ostravské univerzity a FN Ostrava, přednosta: MUDr. J. Dvořáčková, Ph. D., MBA 4
Published in: Rozhl. Chir., 2012, roč. 91, č. 7, s. 381-387.
Category: Case Report

Overview

Echinococcosis, also referred to as hydatidosis, is a parasitic infection caused by the tapeworm Echinococcus in its larval stage. It has worldwide distribution and endemic areas in Europe include especially the regions surrounding the Mediterranean Sea. In the Czech Republic, its incidence tends to be quite rare. Although it may affect any organ or tissue in the human body, the liver (60%) and lungs (20%) are the most frequently affected sites.

The authors present two cases of Bulgarian patients with hepatic echinococcosis operated on the same day at two different surgical departments in the Czech Republic.

Treatment is based on the surgical removal of the cysts in combination with anti-parasite treatment by benzimidazoles (Albendazol, Mebendazol). Treatment with anti-parasitic drugs needs to be started preoperatively and should continue for at least 1–2 months after surgery. The success of the treatment can be monitored by imaging methods, especially PET/CT and serology. Patients after surgical as well as conservative therapy need to be followed up on an outpatient basis due to the long-term risk of recurrence.

Key words:
echinococcosis – Albendazol – Habib Sealer 4X®


Sources

1. Aydin Ü, Yazici P, Önen Z et al. The optimal treatment of hydatid cyst of the liver: Radical surgery with a significant reduced risk of recurrence. Turk J Gastroenterol 2008;19:33–39.

2. Buttenschoen K, Buttenschoen DC. Echinococcus granulosus infection: The challenge of surgical treatment. Langenbecks Arch Surg 2003;388:218.

3. Schweiger A, Ammann RW, Candinas D, Clavien PA, Eckert J, Gottstein B. Human alveolar echinococcosis after fox population increase. Switzerland Emerg Infect Dis 2007;13:878–82.

4. Bruzinskaite R, Marcinkute A, Strupas K, Sokolovas V, Deplazes P, Mathis A. Alveolar echinococcosis, Lithuania. Emerg Infect Dis 2007;13:1618–9.

5. Thompson RCA, Lymbery AJ. Echinococcus and hydatid disease. Wallingford: CAB International 1995;411–63.

6. Wilson JF, Diddams AC, Rausch RL. Cystic hydatid disease in Alaska. A review of 101 autochthonous cases of Echinococcus granulosus infection. Am Rev Respir Dis 1968;68:1–15.

7. Schweiger A, Grimm F, Tanner I et al. Serological diagnosis of echinococcosis: The diagnostic potential of native antigens. Infection 2012;40(2):139–52.

8. Raymond A, Smego Jr., Sebanego P. Treatment options for hepatic cystic echinococcosis. International Journal of Infectious Diseases 2005;9:69–76.

9. Franchi C, Di Vico B, Teggi A. Long-term evaluation of patients with hydatidosis treated with benzimidazole carbamates. Clin Infect Dis 1999;29:304–9.

10. Lacey E. Mode of action of benzimidazoles. Parasitol Today 1990;6:112–5.

11. Hao W, Pei-Fan Z, Wen-Guang Y, Jian L, Yun-Hai W, Jing-Hui Z. Albendazole chemotherapy for human cystic and alveolar echinococcosis in north-western China. Trans R Soc Trop Med Hyg 1994;88:340–3.

12. Saimot AG. Medical treatment of liver hydatidosis. World J Surg 2001;25:15–20.

13. Todorov T, Vutova K, Petkov D, Mechkov G, Koler K. Albendazole treatment of human cystic echinococcosis. Trans R Soc Trop Med Hyg 1988;82:453–9.

14. Senyuz OF, Yesildag E, Celayir S. Albendazole therapy in the treatment of hydatid liver disease. Surg Today 2001;31:487–91.

15. Davis A, Dixon H, Pawlowski Z. Multicentre clinical trials of benzimidazole carbamates in human cystic echinococcosis (phase 2). Bull World Health Organ 1989;67:503–8.

16. Gollackner B, Langle F, Auer H et al. Radical surgical therapy of abdominal cystic hydatid disease: Factors of recurrence. World J Surg 2000;24:717–21.

17. Cirenei A, Bertoldi I. Evolutions of surgery for liver hydatidosis from 1950 to today: Analysis of a personal experience. World J Surg 2001;25:87–92.

18. Vagianos CE, Karavias DD, Kakkos SK, Vagenas CA, Androulakis JA. Conservative surgery in the treatment of hepatic hydatidosis. Eur J Surg 1995;161:415–20.

19. Gloor B, Ly Q, Candinas D. Role of laparoscopy in hepatic cyst surgery. Dig Surg 2002;19:494–9.

20. Chowbey PK, Shah S, Khullar R, Sharma A, Soni V, Baijal M. Minimal access surgery for hydatid cyst disease: laparoscopic, thoracoscopic and retroperitoneoscopic approach. J Laparoendosc Adv Surg Tech 2003;13:159–65.

21. Ertem M, Karahasanoglu T, Yavuz N, Erguney S. Laparoscopically-treated liver hydatid cysts. Arch Surg 2002;137:1170–3.

22. Mueller PR, Dawson SL, Ferrucci JT, Nardi GL. Hepatic echinococcal cyst: Successful percutaneous drainage. Radiology 1985;155(3):627–628.

23. Ustunsoz B, Akhan O, Kamiloglu MA et al. Percutaneous treatment of hydatid cysts of the liver: long-term results. AJR 1999;172:91–6.

24. Deger E, Hokelek M, Deger BA, Tutar E, Asil M, Pakdermirli E. A new therapeutic approach for the treatment of cystic echinococcosis: percutaneous albendazole sulphoxide injection without reaspiration. Am J Gastroenterol 2000;95:248–54.

25. Akhan O, Ozmen MN. Percutaneous treatment of liver hydatid cysts. Eur J Radiol 1999;32:76–85.

26. Jíra J. Lékařská helmintologie. 1. vyd. Praha, Galén 1998: 188–200.

27. Eckert J, Deplazes P. Biological, epidemiological and clinical aspects of echinococcosis, a zoonosis of increasing koncern. Clin Microbiol Rev 2004;(1):107–35.

28. Hozáková L, Vávra P, Mitták M. Cystická echinokokóza – víceorgánové postižení – kazuistika. Český kongres o infekčních nemocech. Mikulov 2011.

29. Horáček J. Echinokokové cysty v játrech, Čs Patologie 1978; 14:37–39.

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Surgery Orthopaedics Trauma surgery
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