Letter to editor about the article: Should Pediatricians be aware of cystic Echinococcosis? A literature review.

T o the Editor: We have read a recent report by Tersigni et al (1) with great interest. This review demonstrated that serological tests and different radiological findings are diagnostic tools in cystic echinococcosis (CE) in European children. Meanwhile, watch-andwait, pharmacological treatment, percutaneous treatment, and surgery are 4 available therapy approaches of CE. However, recently more study claimed that endoscopic retrograde cholangiopancreatography (ERCP) and ERCP-associated techniques play a crucial role in diagnosis and treatment biliary tree CE (2–6). ERCP is an important diagnostic and therapeutic tool for biliary disease in child (7,8). Firstly, ERCP can be used to identify the cystobiliary relations if noninvasive tools to explore the biliary tract are unavailable, which attributes to determinate next treatment means (7,9). Secondly, ERCP is another nonsurgical way to treat cystobiliary communications diseases, especially alleviating jaundice and cholangitis of biliary tree obstruction, as a therapeutic alternative to percutaneous transhepatic biliary drainage (PTDC). ERCP is regarded as an interesting alternative to palliative surgery combined with drug treatment, and never impairs further surgical operation (2). Thirdly, ERCP and ERCP-associated techniques are effective ways to detect and treat the postoperative complications after surgery for biliary hydatid diseases, such as biliary fistulas and biliary obstruction by endoscopic nasobiliary drainage and endoscopic sphincterotomy. It avoids surgical reintervention and decreases hospitalazitation time (2,4). Hence, we suggest emphasizing the ERCP role in diagnosis and treatment of CE in European child. It is absolutely benefited to effectively and safely diagnosis and treatment CE in an early stage.