{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:07:57Z","timestamp":1789459677112,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Cystic echinococcosis is a zoonotic parasitic disease that affects the liver in more than 70% of cases, and there is still an underestimated incidence in endemic areas. With a peculiar clinical presentation that ranges from paucisymptomatic illness to severe and possibly fatal complications, quality imaging and serological studies are required for diagnosis. The mainstay of treatment to date is surgery combined with antiparasitic agents. The surgical armamentarium consists of open and laparoscopic procedures for selected cases with growing confidence in parenchyma-sparing interventions. Endoscopic retrograde cholangiopancreatography (ERCP) is extremely useful for the diagnosis and treatment of biliary fistulas. Recent relevant studies in the literature are reviewed, and two complex cases are presented. The first patient underwent open surgery to treat 11 liver cysts, and during the follow-up, a right pulmonary cyst was diagnosed that was treated by minimally invasive surgery. The second case is represented by the peritoneal rupture of a giant liver cyst in a young woman who underwent laparoscopic surgery. Both patients developed biliary fistulas that were managed by ERCP. Both patients exhibited a non-specific clinical presentation and underwent several surgical procedures combined with antiparasitic agents, highlighting the necessity of customized treatment in order to decrease complications and successfully cure the disease.<\/jats:p>","DOI":"10.3390\/tomography10060070","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T08:45:50Z","timestamp":1718181950000},"page":"922-934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Complicated Liver Cystic Echinococcosis\u2014A Comprehensive Literature Review and a Tale of Two Extreme Cases"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-9109","authenticated-orcid":false,"given":"Valentin","family":"Calu","sequence":"first","affiliation":[{"name":"Elias University Emergency Hospital, 011461 Bucharest, Romania"},{"name":"Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3964-2097","authenticated-orcid":false,"given":"Octavian","family":"Enciu","sequence":"additional","affiliation":[{"name":"Elias University Emergency Hospital, 011461 Bucharest, Romania"},{"name":"Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2057-5448","authenticated-orcid":false,"given":"Elena-Adelina","family":"Toma","sequence":"additional","affiliation":[{"name":"Elias University Emergency Hospital, 011461 Bucharest, Romania"},{"name":"Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu","family":"P\u00e2rvule\u0163u","sequence":"additional","affiliation":[{"name":"Elias University Emergency Hospital, 011461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3461-6183","authenticated-orcid":false,"given":"Dumitru C\u0103t\u0103lin","family":"P\u00eer\u00eeianu","sequence":"additional","affiliation":[{"name":"Elias University Emergency Hospital, 011461 Bucharest, Romania"},{"name":"Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9609-8775","authenticated-orcid":false,"given":"Adrian","family":"Miron","sequence":"additional","affiliation":[{"name":"Elias University Emergency Hospital, 011461 Bucharest, Romania"},{"name":"Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8859116","DOI":"10.1155\/2020\/8859116","article-title":"Review on Epidemiology and Public Health Significance of Hydatidosis","volume":"2020","author":"Gessese","year":"2020","journal-title":"Vet. 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