Medical Treatment of Liver Hydatidosis

The 2001 document outlines the treatment options for liver hydatidosis, highlighting surgery as the primary method but with risks of relapse (2% to 15%) and mortality (0.9% to 20%). Chemotherapy with benzimidazole compounds, specifically albendazole and mebendazole, is considered less invasive and is recommended by the World Health Organization for inoperable cases, though it has a lower apparent cure rate of 20% to 30%. Albendazole is noted as the most effective drug, with a response in over 75% of patients, but it can cause reversible liver enzyme changes and bone marrow suppression in 10% to 20% of patients, as well as alopecia during long-term treatment. The document also reports a relapse rate of 22.7% in a 5-year follow-up study and adverse reactions in 780 patients treated with albendazole. Preoperative benzimidazole treatment is advised to decrease cyst viability and recurrence risk, with a minimum duration of 3 months. The potential for improved efficacy with the combination of praziquantel and albendazole is mentioned. The need for more clinical trials to establish definitive treatment guidelines is emphasized.