Management of biliary obstruction in patients with newly diagnosed alveolar echinococcosis: a Swiss retrospective cohort study

• DOI: 10.57187/smw.2023.40116
• Publication Date: 2023-11-13T18:22:35Z
• Authors: Sandra Müller; Soleen Ghafoor; Cordula Meyer zu ...; Felix Grimm; Fritz Ruprecht Mu...; Lars Husmann; Nadine Stanek; Peter Deplazes; Christoph Schlag; Andreas E. Kremer; Christoph Gubler; Cäcilia S. Reiner; David Semela; Beat Müllhaupt; Ansgar Deibel
• Keywords: Clinical endpoint

Alveolar echinococcosis, an orphan zoonosis affecting the liver, is of increasing concern worldwide. Most symptomatic cases present at advanced and inoperable stage, sometimes with biliary obstruction prompting tract interventions. These are, however, associated a high risk infectious complications. The aim this retrospective study was to compare effectiveness safety conservative interventional treatment approaches in patients newly diagnosed alveolar echinococcosis obstruction.Alveolar treated two referral centres Switzerland, presenting hyperbilirubinaemia (total bilirubin >1.5 Upper Limit Normal) diagnosis were included, unless another underlying aetiology, i.e. common bile duct stones or decompensated cirrhosis, identified. Patients divided into groups, according whether they initially received intervention. primary endpoint normalisation levels within 6-month period. Secondary endpoints among others, occurrence early late complications, need for interventions during follow-up overall duration hospital stays initiation complications.28 included study, whom 17 benzimidazole therapy alone 11 additionally Baseline characteristics did not differ between groups. All but one patient each group achieved (p=0.747). Biliary intervention faster laboratory improvement (t1/2 1.3 vs 3.0 weeks), also more frequent complications (7/11 1/17, p=0.002) longer initial stay (18 days 7 days, p=0.007).Biliary can be effectively alone. intervention, on other hand, complication rate should probably reserved insufficient response therapy.