Ultrasound-guided Percutaneous Puncture, Aspiration, Injection and Reaspiration (pair) for Treatment of Hepatic Hydatid Cysts: a Preliminary Report of University Hospital Volkan Cakir1, Cengiz Tavusbay2, Omur Balli1, Erdinc Kamer2, Emrah Akay1, Haldun Kar2, Ugur Ozgurbuz3, Emir Capkinoglu2,

Aim: The purpose of this study was to analyse the effect and preliminary clinical outcomes of percutaneous puncture, aspiration, injection of scolicidal agent and reaspiration (PAIR) in patients with liver hydatid disease. Materials and methods: Data of a total of 41 patients with a diagnosis of hydatid cyst of the liver who underwent treatment with PAIR procedure were analysed between January 2011 and August 2013. Preprocedural clinical, radiological and laboratory characteristics, and postprocedural morbidity, mortality and length of hospital stay were recorded. Resuts: The mean length of stay in hospital was 1.1 days (ranges 1-3).We performed percutaneous drainage of 68 hydatid cysts in 41 patients with a success rate of 95,1% and a morbidity rate of 17% without any mortality. In our series, minor complication (urticaria) occurred in 1 patient and major complications in 3 patients (anaphylactic shock).Three patients had cystobiliary fistula. The third patient presented with cholangitis findings 3 weeks after PAIR procedure and was managed by endoscopic retrograde cholangiopancreatography sphincterotomy (ERCP) and percutaneous catheter drainage. The follow-up period ranged from 6 to 19 months, with a mean of 10,3months. No recurrence was seen. Conclusion: Percutaneous puncture, aspiration, injection of scolicidal agent and reaspiration using hypertonic saline with adjuvant medical therapy is minimally invasive, safe and effective therapy in the treatment of type I, II and even III liver hydatid cysts. When considering the morbidity, mortality, hospitalization period and costs of surgical treatment, it can be used as an alterna-