Despite increasing international travel activity, there is a lack of experience with parasitic disease in the Western world. We feel it is important to address this gap; therefore, two aspects of surgical treatment of parasitic disease are presented here.
Dr. Ito from Tokyo, Japan, addresses biliary parasitic diseases associated with hepatobiliary carcinoma from an epidemiologic viewpoint . Flukes are classified as group 1 or 2 carcinogens by the World Health Organization (WHO) as well as by the International Agency for Research on Cancer (IARC); schistosomiasis as one example infects 200 million people worldwide being endemic in China, the Philippines, and Indonesia. There are increasing data that schistosoma infection is also an independent risk factor for the development of HCC. Diagnosis is confirmed serologically or by stool test. Efficient anthelmintic therapy can eradicate the disease.
Dr. Bhalla from New Deli, India gives an overview on hydatid disease of the liver that is of special value since echinococcosis also poses a challenge in endemic areas in Central Europe . Classification of liver cysts is a prerequisite to decide on the optimal treatment modality that also includes a “wait-and-see” strategy. Puncture-Aspiration-Instillation of scolicidal agents and Reaspiration (PAIR) is feasible for many cysts without apparent cystobiliary connection. Endocystectomy is the least invasive operative procedure and best for large superficial cysts. Large central cysts with compression of surrounding structures must be treated by pericystectomy or proper liver resection. Pre- and postoperative albendazole therapy increases the rate of cure.
These review articles outline two examples for challenges in surgery caused by parasites. The experience in the respective field can only be generated in high-incidence areas with the necessity to share this knowledge internationally. The following publications on “Parasitic Disease of the GI-Tract” represent this approach.
Conflict of Interest Statement
No conflict of interest to declare.