Current interventional strategy for the treatment of hepatic alveolar echinococcosis. Issue 12 (1st December 2016)

• Record Type: Journal Article
• Authors: Vuitton, Dominique A.; Azizi, Amel; Richou, Carine; Vuitton, Lucine; Blagosklonov, Oleg; Delabrousse, Eric; Mantion, Georges A.; Bresson-Hadni, Solange
• Is Part Of: Expert review of anti-infective therapy. Volume 14:Issue 12(2016)
• Page Start: 1179
• Page End: 1194
• Publication Date: 2016-12-01
• Subjects: Alveolar echinococcosis -- Echinococcus multilocularis -- cholangitis -- hepatectomy -- ex-vivo liver resection -- liver allo-transplantation -- liver auto-transplantation -- percutaneous transhepatic biliary drainage -- endoscopic retrograde cholangio-pancreatography (ERCP) -- per-endoscopic biliary drainage and stenting; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1080/14787210.2016.1240030
• Languages: English
• ISSNs: 1478-7210

Abstract

ABSTRACT: Introduction : The use of various types of invasive interventions combined with anti-infective drugs in the therapeutic strategy of alveolar echinococcosis (AE) has changed during the last 30 years. Areas covered : This article reviews the current respective indications of surgical, percutaneous and perendoscopic interventions in AE and proposes an integrative therapeutic strategy. Expert commentary : Hepatic resection is indicated whenever it is feasible and curative; palliative surgery should be avoided; percutaneous procedures are best adapted to the drainage of the necrotic cavity present in advanced cases; perendoscopic procedures with stenting are best adapted to alleviating the biliary complications that are common and life-threatening in AE patients. Continuous administration of albendazole or mebendazole, without interruption is mandatory in all cases, temporarily (recommended duration: 2 years) after radical lesion resection in patients without immune suppression; for life in all other cases. Long-term follow-up is essential.