Re: The safe use of cetrimide and hypertonic saline for percutaneous ablation of hepatic echinococcal cysts complicated by intrabiliary rupture

Haddad, Maurice C.; Huwaijah, Said H.; Al-Kutoubi, Aghiad

doi:10.1007/s002700010096

Cited by 5 publications

(7 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgery is indicated in cysts of any type that show any form of complication, such as compression of the adjacent organs, jaundice and intrabiliary rupture [7] . However, an isolated report of 3 cases with biliary communication treated with a combination of cetrimide and hypertonic saline as sclerosant has been reported [3] similar to our case. In our patient, because of the presence of the large biliary communication with the sclerotherapy being performed after balloon occlusion, we felt that we need maximum effect of the sclerosing agent in a short time during which the balloon is occluding and hence we proceeded directly with absolute alcohol rather than attempting with a less aggressive agent like hypertonic saline which may not be effective.…”

Section: Discussionmentioning

confidence: 61%

“…In our patient, because of the presence of the large biliary communication with the sclerotherapy being performed after balloon occlusion, we felt that we need maximum effect of the sclerosing agent in a short time during which the balloon is occluding and hence we proceeded directly with absolute alcohol rather than attempting with a less aggressive agent like hypertonic saline which may not be effective. Percutaneous sclerotherapy with absolute alcohol is contraindicated in such cases without blocking the communication due to the risk of the sclerosing agent entering the biliary tree with resultant chemical sclerosing cholangitis [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Surgery is the preferred mode of treatment in these cases, and percutaneous treatment with absolute alcohol is contraindicated due to the risk of chemical sclerosing cholangitis [3] . However, we present a case of hepatic hydatid cyst with a large biliary communication that was successfully treated by percutaneous sclerotherapy with absolute alcohol after balloon occlusion of the biliary communication.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous Alcohol Sclerotherapy of a Hepatic Hydatid Cyst after Balloon Occlusion of a Large Biliary Communication

Varró

Mathew²,

Athyal³

et al. 2011

Med Princ Pract

View full text Add to dashboard Cite

Objective: To present a case of hepatic hydatid cyst with a biliary communication that was not suitable for surgery and hence necessitated sclerotherapy with absolute alcohol after occluding the biliary communication with a balloon catheter. Clinical Presentation and Intervention: A 50-year-old Asian man presented to the surgical emergency department with a 1-year history of repeated attacks of obstructive jaundice and right hypochondrial pain. Ultrasound and contrast computed tomography revealed a cyst, and endoscopic retrograde cholangiopancreatography and cystography revealed a biliocystic communication. An indirect hemagglutination test for echinococcosis showed the presence of antibodies to Echinococcus species at a titer of 8 establishing the diagnosis of hydatid cyst. Although surgery is the accepted modality of treatment in these cases, the patient was deemed unfit for surgery due to his underlying cardiac problem. While percutaneous treatment with absolute alcohol is contraindicated in his case, it was successfully attempted after balloon occlusion of the biliocystic communication. Conclusion: This case showed that in this patient with hepatic hydatid disease and biliocystic communication, who was not fit for surgery, percutaneous sclerotherapy with absolute alcohol after balloon occlusion was successfully performed by an interventional radiologist.

show abstract

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous Alcohol Sclerotherapy of a Hepatic Hydatid Cyst after Balloon Occlusion of a Large Biliary Communication

Varró

Mathew²,

Athyal³

et al. 2011

Med Princ Pract

View full text Add to dashboard Cite

show abstract

“…Those cysts are treated by percutaneous evacuation (PEVAC) or modified catheterization technique (MoCaT) or dilatable multi-function trocar (DMFT). These techniques are based on evacuating whole cystic materials, both germinative and laminated membranes (47)(48)(49)(50). Even though these techniques are effective and safe in the treatment of cysts with a solid component and multivesiculated and multiple daughter cysts; catheter time (13.7 days-72.3 days), hospitalization time (mean 38 days) and morbidity (21%) are higher than the PAIR technique, but comparable to surgery.…”

Section: Percutaneous Treatmentsmentioning

confidence: 99%

PAIR vs Örmeci technique for the treatment of hydatid cyst

Örmeci

2014

Turk J Gastroenterol

View full text Add to dashboard Cite

Hydatid disease is caused by the larval stages of Echinococcus Granulosus. Most patients with hydatid disease have no symptoms, unless there is compression of vital organs such as the hepatic veins, portal vein, hepatic artery in the liver, bronchia in the lungs or the brain, resulting in life threatening complications like anaphylactic shock and sudden death. There are four treatment strategies for cystic echinococcosis (CE)-surgery, percutaneous methods, medical treatments and watch and wait strategies.Medical treatment with albendazol, mebendazole or prazyquentel may cure only 2/3 of patients with CE. More than 30% of patients will reoccur after stopping the treatment. Watch and wait strategy is followed for asymptomatic and small cysts or CE type IV and Type V cysts. Surgical treatments were the gold standard for treatment of CE until the last 30 years. Consequently, surgical methods decreased while percutaneous methods of treatment increased. Due to higher mortality, morbidity, recurrence rates, longer hospital stays and higher costs in comparison to percutaneous methods like PAIR and ÖRMECİ technique, surgical treatment must be limited for the complicated hydatid cyst. Both the PAIR and Örmeci techniques are safe and effective. However, the Örmeci technique offers a simpler, inexpensive method of treatment, with no mortality, lower morbidity, low recurrence rate, while being out patient based. It can be used as the first choice of treatment modality in patients with cysts type CE type one, CE type two, CE Type 3A and CE Type 3B. In this review, treatment modalities for CE, but mainly percutaneous treatment, will be discussed.

show abstract

“…Irritating scolicidals such as 95% ethanol are to be avoided in communicating cysts because of the high risk of sclerosing cholangitis. Instead, 20% hypertonic saline and 5% cetrimide can be reliably used 1,21 . Very large bilio‐cystic fistulas may lead to external biliary fistula formation, retention of bile in the remaining cavity and postoperative infection 22 .…”

Section: Tn(r)c Formulamentioning

confidence: 99%

Classification of hydatid liver cysts

Kjossev

Losanoff

2005

J of Gastro and Hepatol

View full text Add to dashboard Cite

A number of investigations advocate various classification systems for liver hydatid cysts. However, none permits predicting the treatment outcome or making clinical decisions regarding medical treatment; open surgery; punction, aspiration, injection, reaspiration (PAIR); or laparoscopy. An international hydatid disease registry employing an uniform nomenclature and consistent reporting methods would allow more rational comparison of different management strategies. TN(R)C (topography, nature, recurrent, complication) classification is a comprehensive system based on four criteria: location (T), natural history (N), recurrence (R) and complications (C) of the cyst. This pictorial review illustrates the classification and puts accent of its clinical usefulness. The TN(R)C classification provides a standardized description formula of every liver hydatid cyst, permitting multiple comparisons and analyses.

show abstract

Re: The safe use of cetrimide and hypertonic saline for percutaneous ablation of hepatic echinococcal cysts complicated by intrabiliary rupture

Cited by 5 publications

References 2 publications

Percutaneous Alcohol Sclerotherapy of a Hepatic Hydatid Cyst after Balloon Occlusion of a Large Biliary Communication

Percutaneous Alcohol Sclerotherapy of a Hepatic Hydatid Cyst after Balloon Occlusion of a Large Biliary Communication

PAIR vs Örmeci technique for the treatment of hydatid cyst

Classification of hydatid liver cysts

Contact Info

Product

Resources

About