[Treatment concepts for hepatic echinococcosis]

Area of Science:

• Parasitology
• Infectious Diseases
• Hepatobiliary Surgery

Context:

• Increasing incidence of cystic echinococcosis (CE) and alveolar echinococcosis (AE) in Germany.
• AE presents as a malignant disease with high morbidity and mortality, unlike CE.
• Benzimidazoles are effective but require lifelong monitoring due to side effects and progression risks.

Purpose:

• To review current treatment strategies for CE and AE in Germany.
• To emphasize the critical role of surgical resection, especially for AE.
• To highlight the benefits and requirements of minimally invasive surgery (MIS) in echinococcosis management.

Summary:

• CE is manageable with drugs and interventions; AE requires more aggressive treatment.
• Surgical resection combined with drug treatment is the only curative approach for echinococcosis.
• Minimally invasive surgery offers reduced risks but demands high surgical expertise and meticulous planning.

Impact:

• Individualized, interdisciplinary risk-benefit assessments are crucial for optimizing AE treatment.
• Advancements in MIS enable broader surgical indications for echinococcosis.
• Improved treatment strategies can reduce the high morbidity and mortality associated with AE.