Which procedure is used in the treatment of hydatid disease of the liver?

Updated: Mar 27, 2020
  • Author: Robert E Glasgow, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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PAIR (puncture, aspiration, injection, reaspiration) is a percutaneous treatment technique for hydatid disease. In this minimally invasive method, a needle is introduced into the cyst under ultrasonographic guidance. Cyst fluid is aspirated and analyzed. Hypertonic saline or ethanol is then injected and reaspirated. PAIRD (puncture, aspiration, injection, reaspiration, drainage) is similar to PAIR except that a catheter is left in place after completion of the procedure. PAIRD is most often used for large cysts.

This percutaneous treatment with sclerosing agents was introduced in the 1980s. Since that time, its use in the treatment of hydatid cysts has been somewhat controversial. However, as this technique has become more common and its safety and efficacy have been reported in the literature, it has been increasingly accepted as a treatment option for hydatid disease. The WHO has supported PAIR as an effective alternative to surgery, though its use is limited.

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