RESUMO
Percutaneous drainage of hydatid cyst is relatively new; and data related to it are limited. The aim of this study was to compare the results of percutaneous aspiration of hepatic hydatid disease and surgical cystectomy with respect to effectiveness and safety. Between September 1998 and April 2001, 24 hepatic hydatid cysts in fifteen patients were treated with percutaneous drainage using one stage drainage technique under ultrasonographic guidance; while 21 cysts in another fifteen patients were treated with surgical cystectomy. The mean observation time was twelve months in both group of patients. Thorough history taking and clinical examinations for all the patients, abdominal ultrasonographic and occasionally CT abdomen, intradermal skin test for hydatid and serum IgG antibodies to E. granulosus were measured by ELISA and to prevent secondary dissemination all patients received Albendazol in dose of 10 mg/kg/body weight daily four weeks before and after procedure in both groups. Follow-up examination showed progressive shrinkage and solidification of cyst which was comparable in both groups. The mean hospital stay was significantly shorter in percutaneous group. Complications were mild and no fatal complications were reported. The most common complication was fever occurred in 5/15 [33.3%] and 3/15 [20%] patients at surgical and drainage groups respectively, urticura occurred in 2/15 [13.3%] at drainage group only anaphylaxis in 2/15[13.3%] and 1/15[6.7%]; recurrance in [6.7%] and [13.3%]; cyst infection in [6.7%] in both groups recpectively.Also peritonitis occurred only in one patient of surgery group. No patient in either group developed shock, biliary rupture or local dissemination. The ecchinococcal antibody titer fell progressively and at the last follow-up visit it was negative in 73.3% and 53.3% of drainage and surgery group respectively. The present study concluded that percutaneous drainage of uncomplicated hepatic hydatid cysts was effective and can be performed safely and it should be a good alternative to surgery for treatment of uncomplicated hydatid cyst and more experience should be gained by dealing with such cases in the presence of specialized center and cooperative medical team