Hydatid cyst of the gallbaldder: A systematic review of the literature

Establishment of primary cystic echinococcosis in laboratory mice: our results in the Balb/c strain

BACKGROUND

Establishment of experimental cystic echinococcosis (CE) in laboratory mice is required for the study of CE. Experimental CE may be established in primary or secondary forms; however, the primary form is more reliable for the study of CE.

AIMS

The aim of the study was to assess the possibility of establishment of primary CE in Balb/c mice via the oral administration of Echinococcus granulosus s.l. eggs.

METHODS

E. granulosus s.s. eggs were obtained from the gravid segments of the adult worms collected from an experimentally infected dog. Thirty-four female Balb/c mice were allocated into 4 groups and were orally infected with E. granulosus s.s. eggs as follows: 1) the mice with normal immunity, a single dose of 1000 eggs, 2) the mice with normal immunity, 3 doses of 500 eggs, 3) immunosuppressed mice, a single dose of 1000 eggs, and 4) immunosuppressed mice, 3 doses of 500 eggs. After 6.5 months, all the mice were opened and their internal organs were examined for the presence of CE cysts. The livers of infected mice were also examined for the presence of E. granulosus s.l. compartments by the PCR method.

RESULTS

There was no developed or developing CE cyst in the abdominal cavities or on the internal organs of all the mice in four groups. In addition, in the molecular study, all the examined liver samples were negative for the parasite material.

CONCLUSION

The results of the present study revealed that Balb/c mice are not a suitable host for establishment of primary CE following the oral administration of E. granulosus s.s. eggs.

Gallbladder Hydatid Cyst: A Review on Clinical Features, Investigations and Current Management

BACKGROUND

Gallbladder hydatid cyst (GBHC) is highly uncommon with an incidence of 0.3-0.4% of all atypically located hydatid cysts. Our personal experience of one case of primary GBHC (PGBHC) managed laparoscopically motivated this systematic review. This study aimed to analyze the demographic characteristics, types [whether primary GBHC (PGBHC) or secondary GBHC (SGBHC)], clinical presentation, laboratory investigations, imaging studies, operative procedure, hospital stay, follow-up and recurrence.

METHODS

A systematic review was performed using preferred reporting items for systematic reviews and meta-analyses guidelines.

RESULTS

Twenty studies, including 22 cases plus one more case managed by us, were included in the review. For PGBHC, the mean age was 48.61 years while for SGBHC it was 47.9 years. PGBHC was more common in females (69.23%) while SGBHC was more common in males (55.55%). Overall, GBHC was more common in females (56.52%). The most common presentation overall was abdominal pain (100%) followed by nausea/vomiting (43.47%). The other common symptoms were nausea/vomiting (61.53%) and Murphy's sign (38.46%) in PGBHC, but jaundice (50%) and fever (30%) in SGBHC. In PGBHC, 50% patients had normal liver function while this was deranged in 66.66% patients with SGBHC. Serology was positive in 50% of PGBHC and 100% in SGBHC. Ultrasonography was positive in 50%, while CT-scan showed 70%. CT-scan was better at detection of SGBHC (100%). The most common operation was open cholecystectomy (78.26%) either isolated or combined. Isolated open cholecystectomy was commonly done in PGBHC (69.23%). Overall, only 56.52% of patients received albendazole, but no recurrence was reported. The average hospital stay was 7.25 days and follow-up ranged from 1 month to 10 years.

CONCLUSION

GBHC mostly affects females with abdominal pain being the most common symptom. Ultrasonography is expedient though CT-scan is more sensitive. Albendazole monotherapy has questionable value. Open cholecystectomy is the most common operation. However, laparoscopy is safe in experienced hands.

Hydatid cyst of gall bladder masquerading as carcinoma: A rare case report with review of literature

Hydatid disease is a parasitic infestation caused by Echinococcus, most commonly Echincoccus granulosus. Liver is the most common location followed by lungs. Hydatid involvement of gall bladder is a very rare entity, which masqueraded as gall bladder cancer. Here, we attempt to highlight the relevance of this rare disease and discuss this unique case of a 60-year-old male, who presented with gall bladder mass, abdominal pain, and vomiting. The patient was eventually diagnosed as Hydatid disease. The patient has been treated on medical management and has shown improvement. The manuscript has discussed diagnosis and management of disease along with review of literature.

Long-Term Results of Percutaneous Management of Liver Hydatid Cysts: - Experience of a University Hospital in Endemic Region

Background and objective: Surgery was considered for years the standard treatment for all stages of liver hydatid cysts (LHC). Percutaneous treatment has becomes a fast, reliable and more efficient method in selected cases. The purpose of this study is to evaluate the effectiveness of percutaneous treatment of LHC on the basis of our department long-term results. Patients and Methods: This study includes all patients who benefited from percutaneous treatment for LHC from December 1998 to April 2012. Puncture aspiration, injection, and re-aspiration (PAIR) were used for hydatid cysts smaller than 6 cm. Larger cysts, infected cysts and those with biliary fistula were treated by puncture associated to drainage (PA-PD). Absolute alcohol was used as sclerosing agent. Reduction of the size of the cyst more than 50%, pseudo-tumour echo pattern and disappearance of the cyst at the follow-up were retained as criteria of treatment efficacy. Results: Two hundred thirty patients (136 female and 94 male; mean age: 35 years old) with 278 LHC underwent percutaneous treatment. Mean initial cyst diameter was 76.8 mm [20-180 mm]. According to Gharbi's classification, types I and II LHC accounted for 74% and 25% respectively. Fourteen patients (6%) presented with an infected cavity and 27 patients (12%) had a biliary fistula at diagnosis (12%). PA-PD was initially performedin 23 patients. No mortality, abdominal dissemination, or tract seeding occurred. Minor complications like urticaria, cutaneous rash and fever were reported in 24 patients (10%). One case of anaphylactic shock was reported with good evolution. Mean hospitalization time was 3 days ± 1.5 for uncomplicated cases and 16.5 days± 4.2 for complicated cases. 229 out of 230 patients were cured, whereas one recurrence has been reported. Conclusion: Percutaneous treatmentis efficient and safe and offers complete cure in selected patients with the advantage of short hospitalization. Keywords: Drainage, Hydatid Cyst, Liver, Morocco, Percutaneous Puncture, Ultrasound (US)