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Letters to the editor
Percutaneous drainage of echinococcal cysts
  1. H G SCHIPPER,
  2. P A KAGER
  1. J S LAMÉRIS
  1. Division of Infectious Diseases
  2. Tropical Medicine and
  3. AIDS Academic Medical Centre
  4. Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
  5. Department of Radiology, Academic Medical Centre
  6. Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
  1. H G Schipper.h.g.schipper{at}amc.uva.nl

https://doi.org/10.1136/gut.48.4.578

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    Editor,—We read with interest the critical reply of Dr Morris (Gut 2000;47:156–7OpenUrlPubMed) to the letter on the use of PAIR (puncture, aspiration, injection, reaspiration) in the treatment of echinococcal cysts. He questioned the safety and efficacy of PAIR and wondered whether there was any other place for PAIR than in situations where surgery was not available. We comment on the risk of sclerosing cholangitis.

    We agree with Dr Morris that injection of scolicidal agents into hydatid cysts is a potential risk for sclerosing cholangitis. However, this complication can be avoided when scolicidals are used for the correct indications. Scolicidals are not advocated at surgery because they have been associated with sclerosing cholangitis. The scolicidal probably enters pericystic liver tissue through breaks in the laminated …

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