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Percutaneous aspiration guided by ultrasonography or computed tomography (CT) is technically simple but has been abandoned because the recurrence rates are nearly 100%.

Aspiration combined with sclerosis with alcohol or other agents has been successful in some patients but has high failure and recurrence rates.

Asymptomatic patients do not require therapy, because the risk of developing complications related to the lesion is lower than the risk associated with treatment.

Patients with hydatid cysts should be treated to prevent complications related to cyst growth and rupture.

If cysts on imaging studies show abnormalities suggestive of cystic tumors, resection is indicated.

Abscesses should be treated at the time of identification, but percutaneous drainage and antibiotics are usually adequate treatment.

Since that time, its use in the treatment of hydatid cysts has been somewhat controversial.

PAIR (puncture, aspiration, injection, reaspiration) is a percutaneous treatment technique for hydatid disease.Contraindications to treatment of symptomatic liver cysts relate mainly to underlying comorbid illnesses that increase surgical risk.In particular, congestive heart failure and liver failure with portal hypertension and ascites increase operative risk.Medical therapy with antihydatid agents (albendazole and mebendazole) is relatively ineffective.These drugs are used as adjuvant treatment, but they do not replace surgical or percutaneous therapy.