Minireviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2015; 21(1): 124-131
Published online Jan 7, 2015. doi: 10.3748/wjg.v21.i1.124
Review of the treatment of liver hydatid cysts
Concepción Gomez i Gavara, Rafael López-Andújar, Tatiana Belda Ibáñez, José M Ramia Ángel, Ángel Moya Herraiz, Francisco Orbis Castellanos, Eugenia Pareja Ibars, Fernando San Juan Rodríguez
Concepción Gomez i Gavara, Rafael López-Andújar, Ángel Moya Herraiz, Francisco Orbis Castellanos, Eugenia Pareja Ibars, Fernando San Juan Rodríguez, Hepatobiliopancreatic Surgery and Transplantation Unit, La Fe University Hospital, 46026 Valencia, Spain
Tatiana Belda Ibáñez, Digestive Surgery, Virgen de los Lirios Hospital, Alcoy, 03804 Valencia, Spain
José M Ramia Ángel, General Hospital Guadalajara, Hepatobiliopancreatic Surgery Unit, 19002 Guadalajara, Spain
Author contributions: Gómez i Gavara C, López-Andújar R and Ramia Ángel JM designed the study; Gómez i Gavara C and Belda Ibáñez T wrote the manuscript; Moya Herraiz Á, Orbis Castellanos F, Pareja Ibars E and San Juan Rodríguez F were involved in editing the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Concepción Gomez i Gavara, Hepatobiliopancreatic Surgery and Transplantation Unit, La Fe University Hospital, s/n, 46026 Valencia, Spain. imgoga@hotmail.com
Telephone: +34-961-245858 Fax: +34-961-246240
Received: July 13, 2014
Peer-review started: July 13, 2014
First decision: August 6, 2014
Revised: September 16, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: January 7, 2015
Processing time: 178 Days and 10.1 Hours
Abstract

A review was carried out in Medline, LILACS and the Cochrane Library. Our database search strategy included the following terms: “hydatid cyst”, “liver”, “management”, “meta-analysis” and “randomized controlled trial”. No language limits were used in the literature search. The latest electronic search date was the 7th of January 2014. Inclusion and exclusion criteria: all relevant studies on the assessment of therapeutic methods for hydatid cysts of the liver were considered for analysis. Information from editorials, letters to publishers, low quality review articles and studies done on animals were excluded from analysis. Additionally, well-structured abstracts from relevant articles were selected and accepted for analysis. Standardized forms were designed for data extraction; two investigators entered the data on patient demographics, methodology, recurrence of HC, mean cyst size and number of cysts per group. Four hundred and fourteen articles were identified using the previously described search strategy. After applying the inclusion and exclusion criteria detailed above, 57 articles were selected for final analysis: one meta-analysis, 9 randomized clinical trials, 5 non-randomized comparative prospective studies, 7 non-comparative prospective studies, and 34 retrospective studies (12 comparative and 22 non-comparative). Our results indicate that antihelminthic treatment alone is not the ideal treatment for liver hydatid cysts. More studies in the literature support the effectiveness of radical treatment compared with conservative treatment. Conservative surgery with omentoplasty is effective in preventing postoperative complications. A laparoscopic approach is safe in some situations. Percutaneous drainage with albendazole therapy is a safe and effective alternative treatment for hydatid cysts of the liver. Radical surgery with pre- and post-operative administration of albendazole is the best treatment option for liver hydatid cysts due to low recurrence and complication rates.

Keywords: Hydatid; Liver Cyst; Echinococcosis; PAIR; Cystectomy

Core tip: Hepatic hydatid disease still exists worldwide. Because of human migration, surgeons in developed countries are encountering patients with hepatic hydatid disease more frequently but may be unfamiliar with the treatment options for this condition. This review article is particularly important because there are no current updates of evidence-based practices for the treatment of hydatid cysts of the liver. Thus, a careful search of the published literature pertaining to this disorder was carried out.