Intrabiliary Rupture In Liver Hydatid Cysts: Results of 20 Years’ Experience

Abstract

To assess the diagnostic tools and results of treatment of biliary rupture observed in liver cyst hydatids, clinical findings of 562 patients with hepatic hydatid disease were reviewed.

Imaging techniques were not very effective to determine intrabiliary ruptures. Rates of rupture sizes determined in the patients were as follows; 22 (%24.7) large, 38 (%42.7) small, and 29 (%32.6) occult. Most frequently utilized procedures for patients with intrabiliary rupture were Roux-en-y cystojejunostomy, tube drainage + omentoplasty, sutured fistula + omentoplasty, and sutured fistula + tube drainage. Of the total 25 external biliary fistulas, 21 closed spontaneously. Of the four fistulas that did not close, one was managed by internal drainage and three by endoscopic sphincterotomy.

Preoperative diagnosis of biliary rupture in liver hydatid cyst allows early planning of operation and helps the surgeon design the operative strategy. In the treatment of cases with large rupture, internal drainage may be proposed.

Key Words:

• Hydatid disease
• biliary rupture
• liver cyst
• Echinococcus granulosis

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Notes on contributors

M. I. Yildirgan

Dr. M. I. Yildirgan, M.D. Departments of General Surgery School of Medicine, Ataturk university, Erzurum-Turkey Tel.: + 90 442 3166333/2213 Fax: + 90 442 3166340 E-mail: [email protected] [email protected]