Echinococcosis surgery: Difference between revisions
Jump to navigation
Jump to search
Aditya Ganti (talk | contribs) |
Aditya Ganti (talk | contribs) |
||
| Line 19: | Line 19: | ||
===PAIR Protocol=== | ===PAIR Protocol=== | ||
The critical points in the PAIR protocol can be summarized below | The critical points in the PAIR protocol can be summarized below | ||
{| class="wikitable" | |||
!PAIR Protocol | |||
!Preferred management | |||
|- | |||
|Prophylaxis pre- & post procedure | |||
|Albendazole | |||
* To be administered 24 to 4 hours before intervention and 15 days to 30 days after intervention according to cyst size | |||
* No treatment if pregnant | |||
|- | |||
|Communication with biliary tree | |||
|ERCP + cystography or cystography alone | |||
|- | |||
|Electrolytes in the fluid | |||
|Not mandatory; may help for assessing the nature of the cyst | |||
|- | |||
|Scolicidal agent to be used | |||
|Hypertonic saline (at least 15 % final concentration in cyst) or 95 % alcohol | |||
|- | |||
|Quantity of scolicide injected | |||
|At least 1/3 of the aspirated quantity | |||
|- | |||
|Evaluation of viability | |||
|Microscopic examination Staining with methylene blue/eosin red | |||
|- | |||
|Needle vs catheter | |||
|Needle for cysts < 5 cm or in multiloculated cysts Catheter for cyst > 5 cm (PAIRD) | |||
|- | |||
|Follow-up | |||
|Every week for the 1st month, then every other month for the 1st year, then every year for 10 years | |||
|} | |||
== References == | == References == | ||
Revision as of 18:38, 30 June 2017
|
Echinococcosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Echinococcosis surgery On the Web |
|
American Roentgen Ray Society Images of Echinococcosis surgery |
|
Risk calculators and risk factors for Echinococcosis surgery |
Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Surgery
Indications for PAIR
Patients with:
- Non-echoic lesion ≥ 5 cm in diameter (CE1m and l)
- Cysts with daughter cysts (CE2), and/or with detachment of membranes (CE3)
- Multiple cysts if accessible to puncture
- Infected cysts
- Pregnant women
- Children >3 years old
- Patients who fail to respond to chemotherapy alone
- Patients in whom surgery is contraindicated
- Patient who refuse surgery
- Patients who relapse after surgery
PAIR Protocol
The critical points in the PAIR protocol can be summarized below
| PAIR Protocol | Preferred management |
|---|---|
| Prophylaxis pre- & post procedure | Albendazole
|
| Communication with biliary tree | ERCP + cystography or cystography alone |
| Electrolytes in the fluid | Not mandatory; may help for assessing the nature of the cyst |
| Scolicidal agent to be used | Hypertonic saline (at least 15 % final concentration in cyst) or 95 % alcohol |
| Quantity of scolicide injected | At least 1/3 of the aspirated quantity |
| Evaluation of viability | Microscopic examination Staining with methylene blue/eosin red |
| Needle vs catheter | Needle for cysts < 5 cm or in multiloculated cysts Catheter for cyst > 5 cm (PAIRD) |
| Follow-up | Every week for the 1st month, then every other month for the 1st year, then every year for 10 years |