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Medical, Surgical, and Combined Approaches in Pediatric Hydatid Liver Disease: A Systematic Review
Amani N Alansari1, Marwa Messaoud2,3,4, Salma Mani2
1Department of Pediatric Surgery, Hamad Medical Corporation, Doha 3050, Qatar.
Insights
Pediatric hydatid liver disease treatment depends on cyst size. Small cysts respond to albendazole, medium cysts to percutaneous intervention, and large cysts to surgery, favoring minimally invasive approaches.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Hepatology
Background:
- Hydatid disease presents unique challenges in children due to anatomical development.
- Effective management strategies for pediatric hydatid liver disease are crucial.
Purpose of the Study:
- To systematically review and evaluate medical, surgical, and combination therapies for pediatric hydatid liver disease.
- To assess the efficacy and safety of different treatment modalities.
Main Methods:
- Comprehensive literature search across major databases (PubMed, Scopus, Web of Science, Cochrane Library).
- Inclusion of controlled trials, cohort studies, and cross-sectional studies up to January 2025.
- Qualitative synthesis of treatment effectiveness, complications, and patient outcomes.
Main Results:
- Treatment success is linked to cyst size: albendazole for small cysts (<5 cm), percutaneous intervention (PAIR) for medium cysts (5-6 cm), and surgery for large cysts (>6 cm).
- Laparoscopic surgery offers benefits over open surgery, including shorter hospital stays and reduced pain.
- Omentoplasty is superior to tube drainage for managing residual cavities post-surgery.
Conclusions:
- Personalized treatment algorithms based on cyst characteristics (size, location, complexity) are recommended.
- Standardized protocols and increased access to minimally invasive techniques are advised.
- Future research should prioritize prospective comparative studies with standardized outcome measures.
Abstract:
Background: Hydatid disease poses unique management challenges in pediatric populations due to developing anatomy and growth considerations. This systematic review evaluates the efficacy and safety of medical, surgical, and combination therapies for pediatric hydatid liver disease. Methods: A comprehensive search of PubMed, Scopus, Web of Science, and Cochrane Library from inception to January 2025 identified studies investigating treatment outcomes in pediatric hydatid liver disease. Data was synthesized through qualitative analysis of treatment effectiveness, complications, and patient outcomes. Results: Fifteen studies were included, comprising controlled trials, cohort studies, and cross-sectional studies. Treatment efficacy correlated significantly with cyst size: small cysts (<5 cm) responded well to albendazole monotherapy (88.3-97.6% success at 6-12 months); medium-sized cysts (5-6 cm) benefited from percutaneous interventions (PAIR) with 97.1% technical success; large cysts (>6 cm) required surgical management. Laparoscopic approaches demonstrated advantages over open surgery, including shorter hospitalization (5.6 ± 2.2 vs. 12.1 ± 1.5 days) and reduced analgesic requirements. Omentoplasty emerged as superior for residual cavity management with fewer complications than tube drainage approaches. Conclusions: This review supports personalized treatment algorithms based primarily on cyst characteristics. The findings recommend standardized protocols incorporating cyst size, location, and complexity as key decision points, with expanded access to minimally invasive techniques. Future research should focus on prospective comparative studies with standardized outcome measures.
