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Is the Adjuvant Albendazole Treatment Really Needed with PAIR in the Management of Liver Hydatid Cysts? A Prospective, Randomized Trial with Short-Term Follow-Up Results

  • Clinical Investigation
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Abstract

Objective

The purpose of this study was to determine the safety and efficacy of adjuvant albendazole medication in percutaneous liver hydatid cyst treatment with puncture, aspiration, injection, and reaspiration (PAIR) method.

Methods

Between November 2007 and May 2011, total of 39 patients with newly diagnosed liver hydatid cyst (total of 77 cysts) were prospectively randomized and enrolled in 3 groups. In the first group, cysts (n = 14) were treated with PAIR without albendazole. In the second (n = 16) and third groups (n = 47), cysts were treated with PAIR with albendazole 1 week before and 1 month after the procedure, with albendazole 1 week before and 3 months after the procedure respectively.

Results

Technical and clinical success rates were 100 and 96.1 % respectively. In 3 of 77 cysts (3.9 %), findings of recurrence were detected on US imaging. All recurrent cysts were in group 1 and recurrence rates in this group were statistically different from cysts of second and third groups (p = 0.005). Side effects of albendazole were detected in 7 of 29 patients (24.1 %), and no statistically significant difference was observed between the second (15.3 %) and third (38.4 %) groups (p = 0.378).

Conclusions

Use of albendazole medication as an adjuvant to percutaneous treatment of liver hydatid cyst decreases the recurrence rate. Although there is no statistically significant difference between groups 2 and 3 in terms of efficacy and recurrence rate, patients in group 3 had a higher rate of side effect. Therefore, we conclude that albendazole treatment 1 week before and 1 month after PAIR treatment is sufficient to reduce/prevent recurrences.

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Conflict of interest

Okan Akhan, Adalet Elcin Yildiz, Devrim Akinci, Baris Dogu Yildiz and Turkmen Ciftci have no conflict of interest.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey

    Okan Akhan, Adalet Elcin Yildiz, Devrim Akinci & Turkmen Ciftci

  2. General Surgery Clinic, Ankara Numune Teaching Hospital, Ankara, Turkey

    Baris Dogu Yildiz

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  1. Okan Akhan
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  2. Adalet Elcin Yildiz
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Correspondence to Okan Akhan.

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Akhan, O., Yildiz, A.E., Akinci, D. et al. Is the Adjuvant Albendazole Treatment Really Needed with PAIR in the Management of Liver Hydatid Cysts? A Prospective, Randomized Trial with Short-Term Follow-Up Results. Cardiovasc Intervent Radiol 37, 1568–1574 (2014). https://doi.org/10.1007/s00270-014-0840-2

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  • DOI: https://doi.org/10.1007/s00270-014-0840-2

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