Ustunsoz Bahri, Ugurel Mehmet Sahin, Uzar Ali Ihsan, Duru Namik Kemal
Department of Radiology, Faculty of Medicine, Gulhane Military Medical Academy, Etlik, 06018 Ankara, Turkey.
Arch Gynecol Obstet. 2008 Jun;277(6):547-50. doi: 10.1007/s00404-007-0498-y.
To present the long-term results of percutaneous treatment of hepatic hydatid cyst in pregnancy.
Six pregnant patients (age range 19-28 years; mean age 23 years) with six hepatic hydatid cysts underwent percutaneous treatment without albendazole prophylaxis. Puncture, aspiration, injection and reaspiration (PAIR technique) were used to treat the cysts. Hypertonic saline solution was used as cytotoxic agent. Follow-up was mainly by sonography every 2 weeks during pregnancy, every third month post-partum for the first year, every 6 months for the second year, and once a year thereafter. The mean follow-up time was 57.5 months.
Before the treatment, average hydatid cyst volume was 2,145 ml that was reduced to 145 ml post-treatment at the time of delivery. The first five cases of the study had solid appearance of the cyst remnant (indicating complete cure) in 22 months. Cystobiliary fistula was suspected in the sixth case three months after delivery. After confirmation of the cystobiliary fistula with cystography, a percutaneous catheter was placed into the postresidual cavity and a nasobiliary catheter was placed into the common bile duct after syphincterotomy. The fistula was closed in 2 weeks. This patient has a follow-up time of 1 year so far without any problem. No mortality, morbidity, fetal loss, abdominal dissemination, or tract seeding was observed among our cases.
Percutanous treatment of hydatid cysts in pregnancy is an efficient and safe procedure in cases where percutaneous treatment is indicated.
介绍妊娠期肝包虫囊肿经皮治疗的长期结果。
6例患有6个肝包虫囊肿的孕妇（年龄范围19 - 28岁；平均年龄23岁）接受了未使用阿苯达唑预防的经皮治疗。采用穿刺、抽吸、注射和再抽吸（PAIR技术）治疗囊肿。使用高渗盐溶液作为细胞毒性剂。随访主要在孕期每2周进行超声检查，产后第一年每三个月检查一次，第二年每六个月检查一次，此后每年检查一次。平均随访时间为57.5个月。
治疗前，包虫囊肿平均体积为2145毫升，分娩时治疗后降至145毫升。该研究的前五例在22个月时囊肿残余呈实性外观（表明完全治愈）。第六例在产后三个月怀疑有胆瘘。经囊肿造影证实胆瘘后，在残余腔内放置一根经皮导管，并在括约肌切开术后将一根鼻胆管放置在胆总管内。瘘管在2周内闭合。该患者迄今为止随访1年无任何问题。在我们的病例中未观察到死亡、发病、胎儿丢失、腹腔播散或穿刺道种植。
对于有经皮治疗指征的病例，妊娠期肝包虫囊肿的经皮治疗是一种有效且安全的方法。
