What is the role of surgery in the treatment of cystic echinococcosis (CE)?

Updated: May 07, 2019
  • Author: Imad S Dandan, MD; Chief Editor: BS Anand, MD  more...
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Answer

The indications and type of surgery are different for cystic echinococcosis (CE) and alveolar echinococcosis (AE).

Cystic echinococcosis

Note the following:

  • Indications: Large liver cysts with multiple daughter cysts; superficially located single liver cysts that may rupture (traumatically or spontaneously); liver cysts with biliary tree communication or pressure effects on vital organs or structures; infected cysts; and cysts in lungs, brain, kidneys, eyes, bones, and all other organs are indications for surgery.

  • Contraindications: General contraindications to surgical procedures (eg, extremes of age, pregnancy, severe preexisting medical conditions); multiple cysts in multiple organs; cysts that are difficult to access; dead cysts; calcified cysts; and very small cysts are contraindications.

  • Choice of surgical technique: Radical surgery (total pericystectomy or partial affected organ resection, if possible), conservative surgery (open cystectomy), or simple tube drainage of infected and communicating cysts for surgical options. The more radical the procedure, the lower the risk of relapses but the higher the risk of complications. Patient care must be individualized accordingly.

  • Laparoscopic approach has gained more acceptance and popularity in recent years.


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