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The aim of this systematic review was to provide \u201cevidence\u2010based\u201d answers to the following questions: Should chemotherapy be used alone or in association with surgery? What is the best surgical technique? When is the percutaneous aspiration injection and reaspiration technique (PAIR) indicated? An extensive electronic search of the relevant literature without limiting it to the English language was carried out using MEDLINE and the Cochrane Library. Key words used for the final search were \u201chydatid cyst,\u201d \u201cliver,\u201d \u201ctreatment,\u201d \u201cmeta analysis,\u201d \u201crandomized controlled trial,\u201d \u201cprospective study,\u201d \u201cretrospective study.\u201d All relevant studies reporting the assessment of one modality of treatment or a comparison of two or several therapeutic methods to treat hydatid cyst of the liver and published in a peer\u2010reviewed journal were considered for analysis. This systematic review allowed us to conclude that chemotherapy is not the ideal treatment for uncomplicated hydatid cysts of the liver when used alone (level II evidence, grade B recommendation). The level of evidence was too low to help decide between radical or conservative treatment (level IV evidence, grade C recommendation). Omentoplasty associated with radical or conservative treatment is efficient in preventing deep abscesses (level II evidence, grade A recommendation). The laparoscopic approach is safe (level IV evidence, grade C recommendation). Drug treatment associated with surgery (level II evidence, grade C recommendation) requires further studies. Percutaneous drainage associated with albendazole therapy is safe and efficient in selected patients (level II evidence, grade B recommendation). The level of evidence is low concerning treatment of complicated cysts.<\/jats:p>","DOI":"10.1007\/s00268-004-7516-z","type":"journal-article","created":{"date-parts":[[2004,8,3]],"date-time":"2004-08-03T16:43:22Z","timestamp":1091551402000},"page":"731-736","source":"Crossref","is-referenced-by-count":182,"title":["Treatment of Hydatid Cyst of the Liver: Where Is the Evidence?"],"prefix":"10.1002","volume":"28","author":[{"given":"Chadli","family":"Dziri","sequence":"first","affiliation":[{"name":"Division of General Surgery, Department of Emergency H\u00f4pital Charles Nicolle Bd 9 Avril 1938 1006 Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Haouet","sequence":"additional","affiliation":[{"name":"Division of General Surgery Surgical Unit A H\u00f4pital Charles Nicolle Bd 9 Avril 1938 1006 Tunis Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abe","family":"Fingerhut","sequence":"additional","affiliation":[{"name":"Department of Surgery Centre Hospitalier Intercommunal 78303 Poissy Cedex France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,8,3]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1983.32.1462"},{"key":"e_1_2_7_3_2","first-page":"419","article-title":"ARC, ACAPEM, et al. 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