Laparoscopic management of hydatid cysts with biliary communication: clips may rescue when suture fails - report of three cases.

Hydatid disease is a parasitic zoonosis caused by the larval form of the Echinococcus worm. Hepatic hydatidosis is the most common form of the disease in humans. Centrally located, large hydatid cysts have the tendency to rupture into the adjoining bile duct and form a fistulous communication. Suture closure of the cysto-biliary communication detected during surgery is recommended to avoid postoperative complications related to bile leak. In the era of minimally invasive surgery, laparoscopic management of the cysto-biliary communication can be challenging, and laparoscopic suturing may not always be feasible. Postoperative endoscopic biliary decompression is necessary in such situations, but it has its own set of potential risk and complications. This case report aimed at presenting a simple and easy technique for laparoscopic closure of the cysto-biliary communication when suture ligation is technically not possible.