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Le traitement percutané des kystes hydatiques est dorénavant une réalité validée par l’OMS

Percutaneous treatment of hydatid cysts is now validated by WHO

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Résumé

L’association du drainage percutané guidé par échographie à l’albendazole, couplée à l’injection d’alcool absolu, représente une alternative actuelle au traitement chirurgical classique des kystes hydatiques, qui est validée par l’OMS. Un opérateur expérimenté et une structure hospitalière sont indispensables. Le traitement des kystes de type 1 ou 2 peut être réalisé à l’aiguille fine, tandis que le recours à un drain est requis pour les kystes de type 3 de réalisation plus difficile. Les kystes de type 4 doivent être traités par chirurgie classique, en attendant des procédés nouveaux en cours d’évaluation. Il faut être certain d’éliminer une communication avec les voies biliaires avant l’injection du produit scolicide, habituellement le sérum salé hypertonique. L’injection d’alcool, outre son action scolicide, a pour but de favoriser la rétraction de la cavité résiduelle.

Summary

Percutaneous drainage of hydatid cysts associated to albendazole therapy represents nowadays a realistic alternative to classical surgery. These new therapeutic modalities are now supported by the World Health Organisation, and therapeutic guidelines are clearly defined. However, experienced hands and hospital unit are required. Fine needle aspiration is used in case of type 1 and 2 cysts, and percutaneous catheter drainage is useful in type 3 cysts. Complex type 4 cysts have to be treated by traditional surgery, until new percutaneous techniques are available. A biliary fistula must be clearly excluded before injection of hypertonic saline. Absolute alcohol may be injected, as a scolicide agent but also in order to induce retraction of the residual cavity.

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Author information

Correspondence to Ch. Bastid.

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Bastid, C., Sahel, J. Le traitement percutané des kystes hydatiques est dorénavant une réalité validée par l’OMS. Acta Endosc 34, 101–109 (2004). https://doi.org/10.1007/BF03008982

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Motsclés

  • albendazole
  • alcool
  • échographie
  • foie
  • hydatidose
  • kyste hydatique
  • mebendazole
  • percutané
  • ponction guidée
  • praziquentel
  • sérum salé hypertonique

Keywords

  • albendazole
  • alcohol
  • echinococcosis
  • guided puncture
  • hydatid cysts
  • hypertonic saline
  • liver
  • mebendazole
  • percutaneous
  • praziquentel
  • sonography