Men S, Hekimoğlu B, Yücesoy C, Arda I S, Baran I
Department of Radiology, SSK Ankara Hastanesi (Social Security Ankara Hospital), Turkey.
AJR Am J Roentgenol. 1999 Jan;172(1):83-9. doi: 10.2214/ajr.172.1.9888745.
Percutaneous treatment of hydatid cysts is relatively new, and the data related to it are limited. The purpose of this study was to provide additional data to strengthen the proof of its effectiveness.
One hundred sixty-eight hepatic cysts in 111 patients were treated using a percutaneous approach under sonographic and fluoroscopic guidance. Cysts smaller than 5 cm in diameter were treated with a one-stage procedure that consisted of puncture of the cyst, aspiration of fluid, and injection and reaspiration of hypertonic saline solution. Larger cysts were treated with a two-stage procedure that consisted of the one-stage procedure followed by catheterization and sclerotherapy with alcohol.
The mean observation time was 19 months (range, 1-48 months). Follow-up examinations showed progressive shrinkage and solidification of the cysts. Early complications occurred in 32 (28.8%) of the 111 patients, including fatal anaphylaxis in one patient, biliary fistula in seven, infection of the cyst in four, persistent serous drainage from the cyst in two, intraperitoneal leakage of cyst fluid in two, urticaria in seven, fever without evidence of infection in seven, and pleural effusion in two. Late complications occurred in four (3.8%) of the 104 patients who underwent follow-up examinations, including local recurrence in three patients and intrabiliary rupture of a cyst in one patient.
Our experience indicates that percutaneous treatment is efficient in the management of hepatic hydatid cysts and that this technique should be considered an alternative to surgery.
肝包虫囊肿的经皮治疗相对较新，与之相关的数据有限。本研究的目的是提供更多数据以强化其有效性的证据。
在超声和荧光透视引导下，采用经皮方法对111例患者的168个肝囊肿进行治疗。直径小于5cm的囊肿采用一期手术治疗，包括囊肿穿刺、液体抽吸以及高渗盐溶液注射和再次抽吸。较大的囊肿采用两期手术治疗，即先进行一期手术，随后进行导管插入术并用酒精进行硬化治疗。
平均观察时间为19个月（范围1 - 48个月）。随访检查显示囊肿逐渐缩小并固化。111例患者中有32例（28.8%）发生早期并发症，包括1例患者发生致命性过敏反应、7例发生胆瘘、4例囊肿感染、2例囊肿持续浆液引流、2例囊肿液腹腔内漏出、7例荨麻疹、7例无感染证据的发热以及2例胸腔积液。在接受随访检查的104例患者中有4例（3.8%）发生晚期并发症，包括3例患者局部复发和1例患者囊肿胆管内破裂。
我们的经验表明，经皮治疗在肝包虫囊肿的管理中是有效的，并且该技术应被视为手术的一种替代方法。
