Pavlidis ET, Galanis IN, Pavlidis TE. Current considerations for the management of liver echinococcosis. World J Gastroenterol 2025; 31(10): 103973 [DOI: 10.3748/wjg.v31.i10.103973]
Corresponding Author of This Article
Theodoros E Pavlidis, PhD, Professor, The 2nd Department of Propaedeutic Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki 54642, Greece. pavlidth@auth.gr
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
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/
World J Gastroenterol. Mar 14, 2025; 31(10): 103973 Published online Mar 14, 2025. doi: 10.3748/wjg.v31.i10.103973
Current considerations for the management of liver echinococcosis
Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis
Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis, The 2nd Department of Propaedeutic Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
Author contributions: Pavlidis ET designed research, contributed new analytic tools, analyzed data and review; Galanis IN analyzed data and review; Pavlidis ET performed research, analyzed data, review, and wrote the paper.
Conflict-of-interest statement: The authors declared no potential conflicts of interest.
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: Theodoros E Pavlidis, PhD, Professor, The 2nd Department of Propaedeutic Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, Thessaloniki 54642, Greece. pavlidth@auth.gr
Received: December 6, 2024 Revised: January 24, 2025 Accepted: February 11, 2025 Published online: March 14, 2025 Processing time: 82 Days and 20.5 Hours
Abstract
Echinococcosis or hydatid disease is induced mainly by Echinococcus granulosus and occasionally by Echinococcus multilocularis (alveolaris) and affects the liver predominantly. Hepatic alveolar echinococcosis is similar to carcinoma in appearance, and without treatment, it can lead to death. Diagnosis is based on current imaging modalities. Surgical management is the cornerstone of treatment. Complete removal of the cyst (total pericystectomy or hepatectomy) ensures a permanent cure and should be the first-choice treatment for cystic disease. Cyst evacuation, partial cystectomy, and drainage or omentoplasty, may be alternative choices in difficult cases. Albendazole, mebendazole and praziquantel are options for treating small cysts and preventing recurrence after surgery. Despite the efforts, alveolar echinococcus is not usually amenable to surgical management, except in the early stage, which is less common, and management by albendazole is indicated. However, there are few recent reports of major operations (ex-vivo hepatectomy, autotransplantation and vascular reconstruction) in advanced stages.
Core Tip: The most common cystic hepatic echinococcosis has a chronic course. Proper elective surgical management or emergency complications is mandatory to ensure good outcomes and a permanent cure. Attention must be given to the early diagnosis of alveolar echinococcosis as surgery can be successful at the initial stage. Otherwise, albendazole treatment is indicated in the final stage.
