Document Detail


Treatment of hydatid cyst of the liver: where is the evidence?
MedLine Citation:
PMID:  15457348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment of hydatid cyst of the liver ranges from surgical intervention (conventional or laparoscopic approach) to percutaneous drainage and to medical therapy. The aim of this systematic review was to provide "evidence-based" answers to the following questions: Should chemotherapy be used alone or in association with surgery? What is the best surgical technique? When is the percutaneous aspiration injection and reaspiration technique (PAIR) indicated? An extensive electronic search of the relevant literature without limiting it to the English language was carried out using MEDLINE and the Cochrane Library. Key words used for the final search were "hydatid cyst," "liver," "treatment," "meta analysis," "randomized controlled trial," "prospective study," "retrospective study." All relevant studies reporting the assessment of one modality of treatment or a comparison of two or several therapeutic methods to treat hydatid cyst of the liver and published in a peer-reviewed journal were considered for analysis. This systematic review allowed us to conclude that chemotherapy is not the ideal treatment for uncomplicated hydatid cysts of the liver when used alone (level II evidence, grade B recommendation). The level of evidence was too low to help decide between radical or conservative treatment (level IV evidence, grade C recommendation). Omentoplasty associated with radical or conservative treatment is efficient in preventing deep abscesses (level II evidence, grade A recommendation). The laparoscopic approach is safe (level IV evidence, grade C recommendation). Drug treatment associated with surgery (level II evidence, grade C recommendation) requires further studies. Percutaneous drainage associated with albendazole therapy is safe and efficient in selected patients (level II evidence, grade B recommendation). The level of evidence is low concerning treatment of complicated cysts.
Authors:
Chadli Dziri; Karim Haouet; Abe Fingerhut
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Publication Detail:
Type:  Comparative Study; Editorial; Review     Date:  2004-08-03
Journal Detail:
Title:  World journal of surgery     Volume:  28     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-09-30     Completed Date:  2005-02-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  731-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Albendazole / therapeutic use
Anticestodal Agents / therapeutic use
Combined Modality Therapy
Echinococcosis, Hepatic / therapy*
Evidence-Based Medicine*
Humans
Laparoscopy
Mebendazole / therapeutic use
Randomized Controlled Trials as Topic
Suction
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticestodal Agents; 31431-39-7/Mebendazole; 54965-21-8/Albendazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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