[Treatment of cystobiliary fistula of hydatid cyst of the liver. Apropos of 33 cases].

33 hydatid cysts of the liver, opened into the biliary tract were reviewed. The biliary fistula was located in the biliary tract: 16 cases in the right, 14 cases in the left, 1 case in the common bile duct, and 3 cases in the gallbladder. (One case had fistula in the gallbladder and the anterior sectorial canal). Surgical treatment was conservative in 21 cases: bipolar drainage in 10 cases and cysto-biliary disconnection in 11 cases. The treatment was radical in 12 cases: Pericystectomy in 5 cases and liver resection in 7 cases. One postoperative death was observed following bipolar drainage-Postoperative biliary fistula was seen in 8 cases, 7 among them appeared following bipolar drainage. The present results prove the inadequacy of bipolar drainage that should be avoided in large fistula. Better results were observed with radical methods with low morbidity and no mortality. When radical methods are impossible, cystobiliary disconnection seems to allow efficient treatment of cystobiliary fistula with very good immediate and long-term results.