Laparoscopic management in hydatid disease of liver: a series of 35 cases

Background: The purpose of this study is to analyse the sociodemographic factors & clinical features of hydatid disease of liver and to emphasize on the safety, efficacy and the role of laparoscopy in its management in the present scenario. Methods: A prospective observational study was done for 35 patients who were diagnosed with and later underwent surgical intervention laparoscopically for hydatid disease of liver over a duration of 3 years from January 2017 to December 2019. Diagnosis was based on the history, clinical examination, ultrasonography of abdomen (USG) and contrast enhanced computed tomography scan of abdomen (CECT).Results: A slight female preponderance with most cases in the 4th decade of life and belonging to rural areas and low socio-economic status. A single cyst in the right lobe of the liver was most common lesion. The most common surgery performed was laparoscopic de-roofing of the cyst with omentoplasty. The most common complication was intra-operative spillage of cyst contents followed by post-operative biliary leak. Conclusions: In the present era laparoscopic surgery is safe, efficacious and plays a crucial role in the management of hepatic hydatid disease with its proven benefits over the conventional surgeries including less morbidity and mortality and reduced rate of recurrence.

Identification of candidate biomarkers of liver hydatid disease via microarray profiling, bioinformatics analysis, and machine learning

Objectives Liver echinococcosis is a severe zoonotic disease caused by Echinococcus (tapeworm) infection, which is epidemic in the Qinghai region of China. Here, we aimed to explore biomarkers and establish a predictive model for the diagnosis of liver echinococcosis. Methods Microarray profiling followed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis was performed in liver tissue from patients with liver hydatid disease and from healthy controls from the Qinghai region of China. A protein–protein interaction (PPI) network and random forest model were established to identify potential biomarkers and predict the occurrence of liver echinococcosis, respectively. Results Microarray profiling identified 1152 differentially expressed genes (DEGs), including 936 upregulated genes and 216 downregulated genes. Several previously unreported biological processes and signaling pathways were identified. The FCGR2B and CTLA4 proteins were identified by the PPI networks and random forest model. The random forest model based on FCGR2B and CTLA4 reliably predicted the occurrence of liver hydatid disease, with an area under the receiver operator characteristic curve of 0.921. Conclusion Our findings give new insight into gene expression in patients with liver echinococcosis from the Qinghai region of China, improving our understanding of hepatic hydatid disease.

Endoscopic Management of Obstructive Jaundice in Pregnancy Due to Hepatic Hydatid Disease

Liver is one of the most common site of hydatid infection. Intra-biliary rupture of the hydatid cyst is a common and serious complication that can occur during course of pregnancy. Early diagnosis and treatment as mortality is high due to cholangitis. Surgical treatment is the definitive option, however but in the presence of cholangitis and pregnancy, ERCP with biliary drainage is the preferred management option.

Comparative Evaluation of Echinococcus Serology with Cytology for the Diagnosis of Hepatic Hydatid Disease

Objectives The purpose of this study is to determine the diagnostic efficacy of enzyme-linked immunosorbent assay (ELISA) in radiologically confirmed liver mass lesions for the diagnosis of hepatic hydatid disease (HHD) and to compare the diagnostic performance of ELISA with fine needle aspiration cytology (FNAC) (taken as standard) for HHD diagnosis. Materials and Methods This retrospective study included blood samples of 223 patients with radiologically confirmed liver mass lesions in which immunoglobulin G (IgG) anti-Echinococcus antibodies were tested using a commercial IgG ELISA (RIDASCREEN, R-Biopharm AG, Darmstadt, Germany). Results of ELISA, ultrasonography, FNAC, and liver function tests were obtained from the hospital information system. ELISA results were compared with those of FNAC to analyze the diagnostic efficacy of ELISA for HHD diagnosis. Statistical Analysis Comparison of the results obtained from ELISA was performed with respect to FNAC results (taken as standard) to analyze the diagnostic efficacy of ELISA for HHD detection. Data has been represented as median (range) or in frequencies. Wilson score was used to assess 95% confidence interval of diagnostic parameters. The analysis was performed using SPSS Version 22.0 (IBM Corp.) and Open Epi (version 3.01). Results Out of 223 cases with liver mass lesions, Echinococcus IgG was reactive in 62 (28%) cases and FNAC was positive in 16 (7.2%) cases. Since two cases were FNAC-positive but IgG-nonreactive, total HHD cases were 64 (28.7%). Echinococcus IgG reactive cases were seen more in the extremes of age group, that is, 1 to 10 years and 81 to 90 years. Taking FNAC as the standard, the sensitivity, specificity, positive predictive value, and negative predictive value of ELISA were 87.5, 76.8, 22.6, and 98.7%, respectively. Cytology-positive cases demonstrated a mean ELISA optical density/cut-off (OD/CO) of 4.2 ± 3 standard deviation. Conclusion ELISA in radiologically confirmed liver mass cases is highly sensitive in detecting HHD and hence should be used along with ultrasonography for the screening of HHD followed by confirmation with cytology even in cases with a higher OD/CO of ELISA.