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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
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Hepatic hydatid: PAIR, drain or resect?

Nikhil Gupta1, Amit Javed, Sunil Puri

  • 1GB Pant Hospital & Maulana Azad Medical College, Delhi University, New Delhi, India.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|August 10, 2011
PubMed
Summary
This summary is machine-generated.

Hydatid disease of the liver management in India involves surgery or percutaneous drainage (PAIR/PAIR-D). Excisional surgery is preferred for minimizing recurrence, but drainage may be safer for cysts near vital structures.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Surgical Gastroenterology

Background:

  • Hydatid disease of the liver is a prevalent health issue in India.
  • Treatment options include pharmacotherapy, radiological interventions, and surgical procedures.
  • The optimal treatment strategy remains a subject of debate.

Purpose of the Study:

  • To retrospectively analyze patient outcomes for hydatid liver disease.
  • To compare the effectiveness of percutaneous aspiration, injection, and reaspiration (PAIR/PAIR-D) versus surgical interventions.
  • To evaluate immediate and long-term results of different management modalities.

Main Methods:

  • Retrospective analysis of 128 patients managed between 2000-2009.
  • Cysts classified using Gharbi's classification.
  • Treatment modalities included PAIR/PAIR-D and conservative or radical surgery.

Main Results:

  • PAIR/PAIR-D was used in 52 patients, radical surgery in 61, and conservative surgery in 33.
  • PAIR had a success rate of approximately 81%, with failures requiring surgery.
  • Conservative surgery showed higher rates of postoperative bile leaks and abscesses compared to radical surgery.

Conclusions:

  • Treatment for hydatid liver disease should be individualized.
  • Percutaneous drainage (PAIR/PAIR-D) is suitable for favorable cysts (Type I and II).
  • Complete excision is preferred for minimizing recurrence, but drainage may be necessary for cysts near critical structures.