Treatment concepts for hepatic echinococcosis

The incidence of both cystic (CE) and alveolar echinococcosis (AE) is increasing in Germany. The CE can often be managed with drug treatment and interventional strategies. In contrast, AE shows characteristics of a malignant disease with a high morbidity and mortality. Benzimidazoles are potent drugs for both entities but with the necessity for a lifelong follow-up and the risk of side effects as well as progression under treatment. Therefore, the indications for surgical resection have to be carefully considered; however, the combination of drug treatment and surgery is the only curative approach. Recently, the use of minimally invasive surgery with reduced morbidity and mortality has justified surgical resection for a broader set of patients; however, minimally invasive surgery requires a high level of expertise and optimal perioperative planning. Therefore, treatment strategies, especially for AE require an individual stratified risk-benefit assessment in an interdisciplinary consensus.

Automated summary

The incidence of cystic and alveolar echinococcosis is increasing in Germany. Drug treatment and surgical resection, especially minimally invasive surgery, are the main therapeutic approaches. Benzimidazoles are effective drugs for both diseases but require lifelong follow-up and carry the risk of side effects and treatment progression. Individual risk-benefit assessment is needed for treatment strategies, especially for alveolar echinococcosis.