AIM: Intrabiliary rupture (IBR) is a common and serious complication of hepatic hydatid cyst. The incidence varies from 1% to 25%. The treatment of IBR is still controversial. We aimed to design an algorithm for the treatment of hepatic hydatidosis with IBR by reviewing our cases. METHODS: Eight cases of IBR were analyzed retrospectively. Patients were evaluated according to age, sex, clinical findings, cyst number and stage, abdominal ultrasonography and CT-scan, surgical methods, complications, results and coincidental diseases. RESULTS: Female/male ratio was 1/7. Mean age was 52.12+/-18.26 years (range 24-69 years). Right upper quadrant pain, flatulence, palpable hepatic mass were symptoms common in all patients. Cholestatic jaundice was found in four cases. In all patients, cyst evacuation and omentoplasty were performed, followed by either choledochoduodenostomy, T-tube drainage, intracavitary suturing of the orifice, two cases in each. Whereas in two patients diagnosed post-operatively percutaneous drainage of biliary collection or ERCP and sphincteroplasty were added. Morbidity and hospital stay were higher in these cases. CONCLUSION: When the diagnosis of IBR can be done pre- or intra-operatively, morbidity decreases. If a biliary fistula is seen post-operatively, endoscopic procedures such as ERCP, sphincteroplasty or nasobiliary drainage can be applied.
AIM: Intrabiliary rupture (IBR) is a common and serious complication of hepatic hydatid cyst. The incidence varies from 1% to 25%. The treatment of IBR is still controversial. We aimed to design an algorithm for the treatment of hepatic hydatidosis with IBR by reviewing our cases. METHODS: Eight cases of IBR were analyzed retrospectively. Patients were evaluated according to age, sex, clinical findings, cyst number and stage, abdominal ultrasonography and CT-scan, surgical methods, complications, results and coincidental diseases. RESULTS: Female/male ratio was 1/7. Mean age was 52.12+/-18.26 years (range 24-69 years). Right upper quadrant pain, flatulence, palpable hepatic mass were symptoms common in all patients. Cholestatic jaundice was found in four cases. In all patients, cyst evacuation and omentoplasty were performed, followed by either choledochoduodenostomy, T-tube drainage, intracavitary suturing of the orifice, two cases in each. Whereas in two patients diagnosed post-operatively percutaneous drainage of biliary collection or ERCP and sphincteroplasty were added. Morbidity and hospital stay were higher in these cases. CONCLUSION: When the diagnosis of IBR can be done pre- or intra-operatively, morbidity decreases. If a biliary fistula is seen post-operatively, endoscopic procedures such as ERCP, sphincteroplasty or nasobiliary drainage can be applied.
Authors: A N Rodriguez; A L Sánchez del Río; L V Alguacil; J F De Dios Vega; G M Fugarolas Journal: Gastrointest Endosc Date: 1998-12 Impact factor: 9.427
Authors: Tilmann Graeter; Franziska Ehing; Suemeyra Oeztuerk; Richard Andrew Mason; Mark Martin Haenle; Wolfgang Kratzer; Thomas Seufferlein; Beate Gruener Journal: World J Gastroenterol Date: 2015-04-28 Impact factor: 5.742