Value of cyst localization to predict cystobiliary communication in patients undergoing conservative surgery with hydatid cyst

Figures & data

Figure 1 A 17-year-old male with pain in the right upper abdomen.

Notes: Axial computed tomography revealed two cysts. One of them was of type 2, localized in segment 7, and 6 cm in diameter. The other was of type 1, localized in segment 5, and 3.5 cm in diameter. Dilatation and hyperdense attenuation materials (daughter vesicles) were observed in common and left hepatic bile duct.

Figure 2 A 20-year-old male with pain in the right upper abdomen.

Notes: Axial CT revealed a cyst. The cyst was of type 4, localized in segment 6, and 4 cm in diameter. CT showed mild–moderate dilatation in the right hepatic bile duct and intrahepatic defect in the subcapsular area of the posterior cyst wall.
Abbreviation: CT, computed tomography.

Table 1 The distribution of the cysts in the liver according to the Couinaud segmental anatomy and the relationship with CBC

Segment	CBC (%)a	Total (%)b
1	1/2 (50)	2 (1.3)
2	3/22 (13.6)	22 (14.5)
3	1/4 (25)	4 (2.6)
4	12/30 (40)	30 (19.7)
5	8/21 (38.1)	21 (13.8)
6	9/27 (33.3)	27 (17.8)
7	7/17 (41.2)	17 (11.2)
8	14/29 (48.3)	29 (19.1)
Total	55/152 (36.2)	155 (100)

Notes:

a The rate of CBC in each stage.

b The rate of cyst localization.

Abbreviation: CBC, cystobiliary communication.

Table 2 The distribution of the cysts in the liver according to lobe anatomy and the relationship with CBC

Lobe	CBC (%)a	Total (%)b
Caudate	1/2 (50)	2 (1.3)
Left	16/56 (28.6)	56 (36.8)
Right	38/94 (40.4)	94 (61.8)
Total	55/152 (36.2)	152 (100)

Notes:

a The rate of CBC in each stage.

b The rate of cyst localization.

Abbreviation: CBC, cystobiliary communication.

Table 3 The distribution of the cysts in the liver according to distance from the hilus and the ratio of CBC

	CBC (%)a	Total (%)b
Hilarc	31/84 (36.9)	84 (55.3)
Peripherald	24/68 (35.3)	68 (44.7)
Total	55/152 (36.2)	152 (100)

Notes:

a The rate of CBC in each stage.

b The rate of cyst localization.

c Segments 1, 3, 4b, 5, and 6.

d Segments 2, 4a, 7, and 8.

Abbreviation: CBC, cystobiliary communication.

Table 4 The distribution of the cysts according to the Gharbi classification and the ratio of CBC

Stage	CBC (%)a	Total (%)b	P-valuec
1	17/62 (27.4)	62 (40.8)	0.108
2	5/17 (29.4)	17 (11.2)
3	23/55 (41.8)	55 (36.2)
4	10/18 (55.6)	18 (11.8)
5	0	0 (0)
Total	55/152	152 (100)

Notes:

a The rate of CBC in each stage.

b The rate of cyst stage for all cysts.

c Fisher’s exact test.

Abbreviation: CBC, cystobiliary communication.

Table 5 The relation of the demographic findings of the cysts and the patients and preoperative laboratory results in terms of CBC

Parameters	Groups		P-value
	CBC (−)	CBC (+)
Age (years)	38.95±14.97	39.77±18.48	NS
Sex, n (%)
Men	17 (53.1)	15 (44.9)	NS
Women	46 (58.2)	33 (41.8)
Number of lesions	1.53±0.90	1.08±0.28	0.002
Diameter of the cysts (mm)	61.57±24.67	93.33±39.28	≤0.001
WBCs (mm^3)	8.88±3.44	9.26±3.50	NS
Hb (g/dL)	12.98±4.12	13.17±4.17	NS
Hct (%)	37.57±9.36	40.21±9.19	NS
TB (mg/dL)	0.63±0.73	1.51±2.67	0.031
DB (mg/dL)	0.34±0.56	0.96±2.09	0.044
AST (U/L)	29.03±33.90	38.08±36.05	NS
ALT (U/L)	37.87±60.3	47.10±57.52	NS
ALP (U/L)	79.32±75.99	235.04±134.75	≤0.001
GGT (U/L)	42.40±42.21	215.06±193.39	≤0.001

Notes: Results are in response to Student’s t test. P-values were considered significant at the α 0.05 level. All values are mean ± SD unless otherwise stated.

Abbreviations: CBC, cystobiliary communication; NS, not significant; WBC, white blood cell; Hb, hemoglobin; Hct, hematocrit; TB, total bilirubin; DB, direct bilirubin; AST, aspartate aminotransferase; ALT, alanine transaminase; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase.

Table 6 The linear regression analyses of predictive factors in determining CBC preoperatively

Model	Unstandardized coefficients		Standardized coefficients	t	Sig
	β	Std error	β
Constant	−0.081	0.129		−0.627	0.532
Number of lesions	−0.120	0.049	−0.177	−2.432	0.017
The diameter of the cysts (mm)	0.005	0.001	0.362	4.853	0.000
ALP	0.001	0.000	0.283	2.440	0.016
GGT	0.001	0.000	0.222	1.946	0.049

Abbreviations: CBC, cystobiliary communication; Std error, standard error; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase.