A new therapeutic approach for the treatment of cystic echinococcosis: Percutaneous albendazole sulphoxide injection without reaspiration

Abstract

OBJECTIVE: In this experimental study, the effectiveness of intracystic injection of albendazole sulfoxide solution was investigated as a new approach to percutaneous treatment in liver hydatid disease. METHODS: Ten naturally infected sheep were selected and divided into two groups: a treatment group (n = 7), and a control group (n = 3). Intracystic injection of albendazole sulfoxide was performed in the first group, whereas the control group received intracystic distillated water injection instead. No reaspiration was performed in any group. RESULTS: During the follow-up period of 6 months, serial sonographic examination revealed a significant decrease in the cyst size, progressive solidification, and complete separation of the germinal and the laminated membranes of hydatid cysts from the pericysts in the treatment group. In the control group, diameters and volumes of cysts were increased. All procedures were done without any complications. During the follow-up-period, liver function tests were normal. After 6 months, all sheep were killed and were examined for macroscopic and microscopic changes. Pathological examination showed pericyst hyalinization, inflammatory cells in the cyst wall, degeneration of laminated and germinal membranes, and necrotic material in the cyst cavity. No viable protoscoleces or daughter cysts were observed. CONCLUSION: Albendazole sulfoxide injection as a scolecidal agent in the percutaneous treatment of cystic echinococcosis seems to be effective in this animal model. Further studies are suggested to evaluate the effectiveness of this procedure in human subjects. (Am J Gastroenterol 2000;95:248-254. (C) 2000 by Am. Coll. of Gastroenterology)