Non-Surgical Management in 336 Patients of Hydatid Disease: 23 Years Experience at Riyadh Military Hospital

Background/Aims: Patients with hydatid cysts (336) were studied at Riyadh Military Hospital, Saudi Arabia, between February 1985-June 2008, out of which 254 patients underwent non-surgical management and 82 patients had surgery. Methodology: Drug therapy was administered to 194 of 254 patients: albendazole was administered in 65 patients; (albendazole+praziquantel) in 129 patients; 12 patients had endoscopic management; 48 patients had Percutaneous-Aspiration-Injection-Reaspiration (PAIR) and 82 patients had surgery. Results: Out of 65 patients, 34 had completed albendazole of which 12 (35%), had cyst disappearance, 8 patients had partial cyst reduction, 12 had no response and were referred for combined therapy or PAIR; 66 patients with cysts in different organs completed the study using albendazole+praziquantel, in 50% of these cysts had disappeared and 16 (24%) observed reduction of cysts; 48 patients underwent PAIR, of which in 36 cysts (66.66%) disappeared; 82 patients had surgery and 20% had post-surgical complications. Conclusion: A great advance recently has happened in the non-surgical management of hydatid cysts including medical, PAIR and endoscopic management, which has led to a significant reduction in the need for surgical intervention.