Hydatid disease is a parasitic infection caused by Echinococcus granulosus, and the most frequently affected organ is the liver. Diagnosis is usually based on radiological and serological findings. Even though percutaneous drainage and medical therapies are suggested for selected cases, for the most part surgery is required. The surgical strategy consists of killing the cyst, removing its contagious elements from the liver, obliterating the cystic cavity, and preventing recurrence and complications. A large spectrum of operations - from simple drainage to liver transplantation - has been proposed for reaching these objectives. Laparoscopic surgery is used increasingly for hydatid disease. This article reviews the current status of hydatid disease surgery, with special emphasis on liver cysts.

Introduction A proximal occlusion of the posterior cerebral artery (PCA) can affect patients severely and clinical outcome might be poor. Aim of this paper is to describe clinical presentation, diagnostic findings and outcome of patients suffering from ischemia in the PCA territory. Methods We conducted a retrospective analysis of clinically affected patients with imaging-based evidence of ischemia within in the PCA territory at a comprehensive stroke center over a six-year period. Clinical (including demographics, National Institutes of Health Stroke Scale, NIHSS, modified Rankin Sclae, mRS), imaging (including occlusion site and brain infarction) and therapeutic data were evaluated. A favorable outcome was defined as an mRS ≤2. Results Two hundred thirty-five patients were clinically affected with evidence of PCA ischemia detected by cross-sectional imaging. One-hundred fourty-five patients demonstrated an occlusion of the PCA including 43/145 (30%) with P1 occlusion, 80/145 (55%) with P2 and 22/145 (15%) with P3 occlusion. The most frequent symptom was hemi−/ quadrantanopsia (181/235, 77%). Sixty-eight patients (29%) suffered from hemiparesis. The occurrence of a hemiparesis was associated with a P1 occlusion (27/43, 63% vs. 41/192, 21%; p < 0.0001). Hemi−/quadrantanopsia was less frequently associated with a P1 occlusion (26/43, 61% vs. 155/192, 81%; p = 0.0043). P1 occlusions more frequently showed thalamic infarction (28/43, 65% vs. 65/192, 34%; p < 0.0001). At discharge, patients with P1 occlusion more often showed a poor outcome (mRS > 2, 30/43, 70% vs. 55/192, 29%; p < 0.0001). Conclusion Hemiparesis due to P1 occlusion is a common phenomenon in stroke patients and associated with a poor clinical outcome.

ZusammenfassungDer Name Abraham Vater ist international mit der Mündung des Ductus choledochus und des Ductus pancreaticus assoziiert. Vor 300 Jahren wurden Vaters Schriften zusammen mit den wichtigsten anatomischen Publikationen dieser Zeit veröffentlicht. In seinen Experimenten untersuchte er insbesondere die Vereinigung beider Gänge und deren physiologische Bedeutung. Die Papilla duodeni major ist in dieser Publikation weder Bestandteil der Experimente, noch beschreibt Vater sie detailliert. Abraham Vater trägt in seiner Schrift vielmehr das damalige Wissen über diese anatomische Region zusammen und diskutiert dieses.