Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2024; 30(5): 462-470
Published online Feb 7, 2024. doi: 10.3748/wjg.v30.i5.462
Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China
Yu-Peng Li, Jie Zhang, Zhi-De Li, Chao Ma, Guang-Lei Tian, Yuan Meng, Xiong Chen, Zhi-Gang Ma
Yu-Peng Li, Jie Zhang, Zhi-De Li, Chao Ma, Guang-Lei Tian, Yuan Meng, Xiong Chen, Zhi-Gang Ma, Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Author contributions: Li Y designed and performed the research and wrote the manuscript; Ma Z designed the research and supervised the manuscript preparation; Zhang J, Li Z, and Ma C designed the research and contributed to the data analysis; Tian G, Meng Y, and Chen X provided clinical advice; all authors have read and approved the final manuscript to be published.
Institutional review board statement: The protocol was approved by the Ethics Committee of People's Hospital of Xinjiang Uygur Autonomous Region, China.
Informed consent statement: The informed consent was obtained from the subject(s) and/or guardian(s).
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset are accessible through the corresponding author. Participants provided informed consent for sharing their data.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Gang Ma, MD, Doctor, Professor, Department of Hepatobiliary Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Urumqi 830000, Xinjiang Uygur Autonomous Region, China. ma.zhigang@aliyun.com
Received: November 1, 2023
Peer-review started: November 1, 2023
First decision: December 6, 2023
Revised: December 19, 2023
Accepted: January 11, 2024
Article in press: January 11, 2024
Published online: February 7, 2024
Processing time: 90 Days and 14 Hours
Abstract
BACKGROUND

Some hydatid cysts of cystic echinococcosis type 1 (CE1) lack well-defined cyst walls or distinctive endocysts, making them difficult to differentiate from simple hepatic cysts.

AIM

To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.

METHODS

The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region (China) from January 2018 to September 2023 were retrospectively analyzed. Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis, routine abdominal ultrasound, high-frequency ultrasound, abdominal computed tomography (CT) scan, and laparoscopy. Subsequent to the treatments, these patients underwent reexaminations at the outpatient clinic until October 2023. The evaluations included the diagnostic precision of diverse examinations, the efficacy of surgical approaches, and the incidence of CE recurrence.

RESULTS

All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan. Among them, 16 patients were preoperatively diagnosed with atypical CE1, and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound. All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy, of whom 14 patients were intraoperatively confirmed to have CE1, which was consistent with the postoperative pathological diagnosis, one patient was diagnosed with a mesothelial cyst of the liver, and the other was diagnosed with a hepatic cyst combined with local infection. Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts, 4 received aspiration sclerotherapy of hepatic cysts, and 19 received laparoscopic fenestration. These patients were intraoperatively diagnosed with simple hepatic cysts. During the follow-up period, none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices. One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.

CONCLUSION

Abdominal high-frequency ultrasound can detect CE1 hydatid cysts. The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.

Keywords: Hepatic echinococcosis; Hepatic cystic echinococcosis type 1; Hepatic cyst; Color Doppler ultrasound; Laparoscopy

Core Tip: This retrospective study investigated the diagnostic methods for atypical hepatic cystic echinococcosis type 1 (CE1) and evaluated the clinical efficacy of laparoscopic surgeries. In total, 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal computed tomography scan. Among them, 16 patients were preoperatively diagnosed with atypical CE1, of whom 14 were diagnosed with CE1 intraoperatively after laparoscopy. The remaining 77 patients were diagnosed with simple hepatic cysts by high-frequency ultrasound, of whom 4 patients received aspiration sclerotherapy of hepatic cysts, and 19 patients were intraoperatively diagnosed with simple hepatic cysts. Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.