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World J Gastroenterol. Jul 28, 2026; 32(28): 118370
Published online Jul 28, 2026. doi: 10.3748/wjg.118370
Published online Jul 28, 2026. doi: 10.3748/wjg.118370
Percutaneous vs surgical management of hepatic cystic echinococcosis: A perspective on evolving clinical pathways
Xin-Ying Zhang, Wen-Na Cao, Ke-Feng Jia, Department of Interventional Radiology, Central Hospital, Tianjin University/Tianjin Third Central Hospital, Tianjin 300170, China
Bao-Qi Li, Department of Oncology, Tianjin Third Central Hospital, Nankai University, Tianjin 300170, China
Zi-Li Zhang, Department of Gastrointestinal Oncology, Central Hospital, Tianjin University/Tianjin Third Central Hospital, Tianjin 300170, China
Qi Xin, Department of Pathology, Tianjin University/Tianjin Third Central Hospital, Tianjin 300170, China
Co-first authors: Xin-Ying Zhang and Bao-Qi Li.
Co-corresponding authors: Qi Xin and Ke-Feng Jia.
Author contributions: Zhang XY and Li BQ contributed equally to this work and are co-first authors. Zhang XY contributed to conceptualization and methodology; Zhang XY and Li BQ contributed to writing and editing; Cao WN and Zhang ZL contributed to literature screening and manuscript refinement; Xin Q and Jia KF contributed equally as co-corresponding authors. Xin Q and Jia KF provided critical revisions for scientific rigor and approved the final version. Jia KF is the primary corresponding author for all communications and administrative requirements. All authors read and approved the final manuscript.
Supported by Tianjin Science and Technology Project, No. 24JCZDJC01270; Tianjin Third Central Hospital Research Project, No. 2019YNR3; Beijing Medical Award Foundation, No. YXJL-2020-0972-1216; Tianjin Health Science and Technology Project, No. TJWJ2024MS023; and Tianjin Municipal Education Commission Scientific Research Project, No. 2025ZXZD002.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Ke-Feng Jia, Department of Interventional Radiology, Central Hospital, Tianjin University/Tianjin Third Central Hospital, No. 83 Jintang Road, Hedong District, Tianjin 300170, China. jiakefeng20102@163.com
Received: December 31, 2025
Revised: February 6, 2026
Accepted: March 6, 2026
Published online: July 28, 2026
Processing time: 190 Days and 19 Hours
Revised: February 6, 2026
Accepted: March 6, 2026
Published online: July 28, 2026
Processing time: 190 Days and 19 Hours
Core Tip
Core Tip: Hepatic cystic echinococcosis management is less challenged by a lack of therapeutic options than by rational, cyst-specific decision-making. Percutaneous interventions are safe and effective for cysts classified by World Health Organization as CE1 and CE3a, offering advantages in efficiency; while surgery remains essential for large cysts and those with complex biliary involvement or high-risk anatomy. Large real-world data further identify cyst volume as a major determinant of biliary complications, independent of treatment modality. Rather than competing strategies, percutaneous and surgical approaches should be integrated into dynamic, risk-adapted clinical pathways guided by cyst biology, anatomy, and procedural burden.