Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 14, Issue 12, Pages 1179-1194Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2016.1240030
Keywords
Alveolar echinococcosis; Echinococcus multilocularis; cholangitis; hepatectomy; ex-vivo liver resection; liver allo-transplantation; liver auto-transplantation; percutaneous transhepatic biliary drainage; endoscopic retrograde cholangio-pancreatography (ERCP); per-endoscopic biliary drainage and stenting
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Introduction: The use of various types of invasive interventions combined with anti-infective drugs in the therapeutic strategy of alveolar echinococcosis (AE) has changed during the last 30years.Areas covered: This article reviews the current respective indications of surgical, percutaneous and perendoscopic interventions in AE and proposes an integrative therapeutic strategy.Expert commentary: Hepatic resection is indicated whenever it is feasible and curative; palliative surgery should be avoided; percutaneous procedures are best adapted to the drainage of the necrotic cavity present in advanced cases; perendoscopic procedures with stenting are best adapted to alleviating the biliary complications that are common and life-threatening in AE patients. Continuous administration of albendazole or mebendazole, without interruption is mandatory in all cases, temporarily (recommended duration: 2years) after radical lesion resection in patients without immune suppression; for life in all other cases. Long-term follow-up is essential.
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