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

OBJECTIVE: In this experimental study, the effectiveness of intracystic inj ection 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 gr oups: a treatment group (n = 7), and a control group (n = 3). Intracystic i njection 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 examin ation revealed a significant decrease in the cyst size, progressive solidif ication, and complete separation of the germinal and the laminated membrane s of hydatid cysts from the pericysts in the treatment group. In the contro l group, diameters and volumes of cysts were increased. All procedures were done without any complications. During the follow-up-period, liver functio n tests were normal. After 6 months, all sheep were killed and were examine d for macroscopic and microscopic changes. Pathological examination showed pericyst hyalinization, inflammatory cells in the cyst wall, degeneration o f laminated and germinal membranes, and necrotic material in the cyst cavit y. No viable protoscoleces or daughter cysts were observed. CONCLUSION: Albendazole sulfoxide injection as a scolecidal agent in the pe rcutaneous 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)