Published online May 27, 2014. doi: 10.4254/wjh.v6.i5.293
Revised: January 22, 2014
Accepted: March 17, 2014
Published online: May 27, 2014
Cystic echinococcosis (CE) is a complex, chronic and neglected disease with a worldwide distribution. The liver is the most frequent location of parasitic cysts. In humans, its clinical spectrum ranges from asymptomatic infection to severe, potentially fatal disease. Four approaches exist in the clinical management of CE: surgery, percutaneous techniques and drug treatment for active cysts, and the ”watch and wait” approach for inactive cysts. Allocation of patients to these treatments should be based on cyst stage, size and location, available clinical expertise, and comorbidities. However, clinical decision algorithms, efficacy, relapse rates, and costs have never been properly evaluated. This paper reviews recent advances in classification and diagnosis and the currently available evidence for clinical decision-making in cystic echinococcosis of the liver.
Core tip: Cystic echinococcosis (CE) is a neglected parasitic disease and echinococcal cysts are mostly located in the liver. Therefore, CE should always be included in the differential diagnosis of cystic lesions of the liver. However, diagnosis and clinical management can be difficult because of the combination of clinical variables (cysts stage, size, presence of complications, available expertise and three different treatments that have never been systematically compared). This review summarizes current knowledge and open issues in this field for those hepatologists who have limited or no experience with this complex condition.