Another alternative in the treatment of cystic echinococcosis of the liver (Part four)
SUMMARY
Cystic Echinococcosis is a parasitic disease caused by the mature form of the cestode belonging to the genus Echinococcus, where the definitive hosts are species of dogs. (17)
Although echinococcosis is hyperendemic in Mediterranean countries, the limited knowledge of epidemiological data, the long development time of the disease, and the lack of awareness of the economic damage from zoonoses, result in this disease being underestimated by the population, the media, and by health authorities. (18)
The presence of Echinococcus granulosus is mainly associated with pastoral areas. (19).
Surgical treatment is currently considered the method of choice in the treatment of echinococcosis, (20) but surgical intervention cannot be practiced on very small cysts, numerous in number or difficult to place. It is contraindicated in elderly patients or those with cardiac, renal or hepatic problems, diabetics, etc., as well as in pregnant women.
The PAIR technique was introduced in the mid '80s as a surgical technique for the treatment of hydatid cysts in a less invasive, safer, and more economical manner. (21)
This technique is applicable to liver cysts that according to the WHO classification, belong to CL, CE1, CE2, and CE3. (22)
The aim of this presentation is to inform about the advantages of the PAIR technique for application in suitable cases, and why not, the organization and complete knowledge for its application also in Albania.
Dr. Viktor QERESHNIKU
Specialized surgeon in hepato biliary surgery.
Tirana, September 19, 2012
BIBLIOGRAPHY.
1. Garlaschelli et al., 2004.
Classification by ultrasound of the Informal Working Group on Echinococcosis – World Health Organization.
Stage according to WHO classification. Ultrasound features.
2. Eckert et al. F. 2. Echinococcosis/Hydatidosis: New realities. 2004 – 2007.
ECHINOCOCCOSIS/HYDATIDOSIS:NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07
3. C. Filice, E. Brunetti.
Ultrasound and infectious diseases of the liver. Edimes. Medical Scientific Editions. Pavia. Chapter X. page 131.
4. SEMLALI S, CHAOUIR S. : IMAGING OF HYDATID DISEASE
Medical imaging services.
Military Instruction Hospital Mohamed V. Rabat. Morocco.
5. Eckert and Deplazes. 2004.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO.
Academic Years 2004-05/ 2006-07. Page 54.
6. C. Filice., E. Brunetti. : Ultrasound and infectious diseases of the liver. Edimes. Medical-Scientific Editions – Pavia. 1997. Page 155.
7. Eckert and Deplazes, 2004.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOL ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07. Page 57.
8. Eckert et al., 2001.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ;Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07. Page 55
9. McManus et al., 2003.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO.
Academic Years 2004-05/ 2006-07. Page 55.
10. Ammann and Eckert, 1996; De Rosa et al., 1996; Horton,1997.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07. Page 56.
11. Eckert 2001 et al :
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07. Page 56.
12. C. Filice., E. Brunetti. : Ultrasound and infectious diseases of the liver. Edimes. Medical-Scientific Editions – Pavia. 1997. Page 150.
13. Brunetti et al. 2004 :
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07. Page 56.
14. Eckert et al., 2001.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ; Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07. Page 57.
15. Italian Journal of Ultrasound; 2005. 8(2). 141-149.
Ultrasound management of hydatid cysts
M. Caremani*, L. Lapini*, D. Tacconi*, P. Giorni*, A. Caremani**
Infectious Diseases Department - S. Donato Hospital - Arezzo; ** Section of Hematology - S. Donato Hospital – Arezzo. Page 148.
16. Filice C, E Brunetti.
Acta Trop. 1997 Apr 1, 64 (1-2) :95-107.
The use of PAIR in human cystic echinococcosis.Division of Infectious and Tropical Diseases, IRCCS S. Matteo, University of Pavia, Italy.
17. Zhang and McManus, 2006. Page 5.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ;Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07.
18. Bortoletti, personal data; Mantovani and Lasagna, 2004; Poglayen et al., 2007. Page 3.)
Garippa et al., 2004. Page 19 )
19. Garippa et al., 2004. Page 19.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ;Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07.
20. Eckert et al., 2001. Page 52.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ;Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07.
21. Brunetti et al. 2004. Page 54.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ;Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07.
22. Eckert and Deplazes, 2004. Page 54.
ECHINOCOCCOSIS/HYDATIDOSIS: NEW REALITIES
Dr. Maria Paola MAURELLI ; Prof. Giuseppe CRINGOLI ;Prof. Giuseppe PAINO
Academic Years 2004-05/ 2006-07.
Greetings! I would like to have contact with Dr. Viktor Qershniku because my mother has such a disease. She has been operated on twice within a four-year period and it has recurred again. I would like a consultation from your side. Thank you!
Sent by Monika, më 24 October 2017 në 06:04
Dear Monika,
Can you contact me by phone at
Number 0672161158.
With respect,
Viktori
Replay from Dr. Viktor QERESHNIKU, më 24 October 2017 në 13:13
Hello doctor. Many doctors suspect that my mom has this kind of disease, but the examinations conducted at the American Hospital in Tirana show that she has a cyst with fluid in the liver. She has been treated with medications recommended by the American Hospital and herbal remedies for almost 6 months and there has been no result. Please respond to this case because I am very worried about it. Once again, I am pleading
Sent by Eva Mucmata, më 18 February 2019 në 00:38
Honored ....... ,
I recommend that in your possibility of consulting the patient in Tirana, to send me the Echos made in Kukës and in Tirana as well as all the analyses available, as well as to inform me about the concerns of the patient.
Do you have a dog at home?
With respect,
Viktor QERESHNIKU
Replay from Dr. Viktor QERESHNIKU, më 18 February 2019 në 01:59
Dear Eva,
I recommend that if you have the possibility to consult the patient in Tirana, to send me the Echos done in Kukës and in Tirana as well as all the available analyses, and to inform me about the patient's concerns.
Do you keep a dog at home?
With respect,
Viktor QERESHNIKU
Replay from Dr. Viktor QERESHNIKU, më 18 February 2019 në 02:01
Hello doctor, my father has cysts in his liver, one is 9cm and another is 6cm. They have told him to undergo surgery but my father does not want to do it now but rather in October. I would like to know if there is a possibility that the cysts could rupture and what kind of risk comes from the rupture of a cyst?
Please return an answer.
Thank you!
Sent by Majlinda, më 06 May 2019 në 11:37
Honorable Majlinda,
as you have been informed, I believe, you must be aware that echinococcus cysts are in various stages of development, depending on which the treatment also depends. With as much as you have informed, I cannot give a precise answer on how to proceed.
However, it is important to start treatment with ALBENDAZOLE 2 x 400 Mg. Once daily for 28 days, 14 days break, and then repeat another two cycles.
After these cycles, do a good ultrasound and the antigen analysis.
We can communicate further in the future.
Regards
Replay from Dr. Viktor QERESHNIKU, më 08 May 2019 në 09:38
Hello Dr. Viktori. I am Silvana and my mom has a cyst in her liver. The doctor recommended not to treat it for 6 months. Is it normal not to take any medicine during this time? And can it heal without treatment? With respect, Silvana from Lushnja
Sent by Mikela Xhyra, më 07 July 2019 në 13:23
Dear Silvana,
If it has been proven to be a
CYST OF THE CYSTIC ECHINOCOCCUS OF THE LIVER,
of course, it must be treated first
and followed dynamically.
Best regards.
Respect
Replay from Dr. Viktor QERESHNIKU, më 14 July 2019 në 02:29
Honorable Silvana,
If it has been proven to be a
CYST OF THE LIVER HYDATID CYST,
it certainly needs to be treated first
and followed dynamically.
Past events.
Respects
Replay from Dr. Viktor QERESHNIKU, më 14 July 2019 në 02:30
Hello Doctor,
I have a brother with Echinococcosis and it has progressed, recently it has enlarged to 14 by 12 and I wanted to ask you if there is any treatment without surgical intervention. I have also done a scan and it says that it is a Cystic Echinococcus of the Liver.
How can I proceed in this case because I am very confused and honestly, I don't have much faith in surgical interventions
Sent by Maliq Mici, më 04 Agust 2019 në 23:57
Dear Maliq,
When the diagnosis is confirmed,
Treatment must begin with
ALBENDASOL 2X400 Mg daily for
at least 1 to 2 cycles of 21 days and
Then there are 2 alternatives:
1. Open surgery with a scalpel
2. PAIR technique without opening, which
maybe should be inquired at the American Hospital if they perform it.
It should not be left untreated.
Best regards
Replay from Dr. Viktor QERESHNIKU, më 09 Agust 2019 në 03:59
Dear Maliq,
When the diagnosis is confirmed,
Treatment must begin with
ALBENDAZOLE 2X400 Mg per day for
at least 1 to 2 cycles of 21 days and
Then there are 2 alternatives:
1.: Open surgery with scalpel
2.: PAIR technique without incision, which
maybe should be inquired at the American Hospital if they do it.
It should not be left untreated.
Best regards
Replay from Dr. Viktor QERESHNIKU, më 09 Agust 2019 në 03:59
Where can we find you for a visit, please the address, phone, and do we need to make an appointment?
Sent by Nora, më 14 September 2019 në 19:34
With pleasure, we can communicate
to help you as much
as we can.
I am in Tirana and my phone number
is 0682151598.
Regards,
Viktori
Replay from Dr. Viktor QERESHNIKU, më 15 September 2019 në 10:25