The Etiologies of Biliary Fistula Following Open Resection of Hepatic Hydatid Cyst

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, School of Medicine, Isfahan, Iran

2 Assistant Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, School of Medicine, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Hydatidosis is a protozoal disease caused by Echinococcus granulosus, and presents as an endemic disease in Iran. Hepatic hydatid cyst is the most common involved body organ that requires surgical cyst resection in case of being symptomatic. Among most serious complications of hydatid cyst surgery is biliary fistula. The current study aimed to assess the etiologic factors of biliary fistula incidence.Methods: This was a census retrospective cross-sectional study conducted on 69 patients underwent open hydatid cyst resection in Alzahra hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during the years 2015-18. Patients' information including age, gender, previous history of hepatic surgery, cyst diameter, cyst location, and serum level of alkaline phosphatase (ALP) prior to surgery were recorded. Then, patients were followed considering the incidence of biliary fistula. Association of mentioned factors with biliary fistula occurrence was assessed.Findings: 15 patients (21.7%) presented biliary fistula. No statistical association was found between the incidence of biliary fistula and gender (P = 0.08), age (P = 0.75), position of hydatid cyst (P = 0.89), hydatid cyst size (P = 0.37), previous history of surgery (P = 0.50), and serum level of ALP prior to the surgery (P = 0.26).Conclusion: Based on findings of the current study, no significant association was detected between the incidence of biliary fistula following open resection of hydatid cyst and factors such as age, gender, previous history of hepatic surgery, cyst size, cyst location, and serum levels of ALP. Further studies with greater study populations are recommended.

Keywords

References

  1. Zeybek N, Dede H, Balci D, Coskun AK, Ozerhan IH, Peker S, et al. Biliary fistula after treatment for hydatid disease of the liver: When to intervene. World J Gastroenterol 2013; 19(3): 355-61.
  2. Safioleas MC, Misiakos EP, Kouvaraki M, Stamatakos MK, Manti CP, Felekouras ES. Hydatid disease of the liver: A continuing surgical problem. Arch Surg 2006; 141(11): 1101-8.
  3. Mihmanli M, Idiz UO, Kaya C, Demir U, Bostanci O, Omeroglu S, et al. Current status of diagnosis and treatment of hepatic echinococcosis. World J Hepatol 2016; 8(28): 1169-81.
  4. Yiallourou AI, Nastos C, Theodoraki K, Papaconstantinou I, Theodosopoulos T, et al. Surgical Management of major complications of hydatid cysts of the liver- a review of the literature. Ann Clin Cytol Pathol 2017; 3(1): 1049.
  5. Alghofaily KA, Saeedan MB, Aljohani IM, Alrasheed M, McWilliams S, Aldosary A, et al. Hepatic hydatid disease complications: review of imaging findings and clinical implications. Abdom Radiol (NY) 2017; 42(1): 199-210.
  6. Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, et al. The economic burden of physical inactivity: A global analysis of major non-communicable diseases. Lancet 2016; 388(10051): 1311-24.
  7. Anand S, Rajagopalan S, Mohan R. Retraction notice to "Management of liver hydatid cysts - Current perspectives" [Medical Journal Armed forces India 68 (2012) 304-309]. Med J Armed Forces India 2017; 73(1): 104.
  8. Agarwal S, Sikora SS, Kumar A, Saxena R, Kapoor VK. Bile leaks following surgery for hepatic hydatid disease. Indian J Gastroenterol 2005; 24(2): 55-8.
  9. Dinakar Reddy A, Thota A. Cysto-biliary communication (CBC) in hepatic hydatidosis: Predictors, management and outcome. Int Surg J 2019; 6(1): 61-5.
  10. Kilic M, Yoldas O, Koc M, Keskek M, Karakose N, Ertan T, et al. Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter? Am J Surg 2008; 196(5): 732-5.
  11. Galati G, Sterpetti AV, Caputo M, Adduci M, Lucandri G, Brozzetti S, et al. Endoscopic retrograde cholangiography for intrabiliary rupture of hydatid cyst. Am J Surg 2006; 191(2): 206-10.
  12. Rajabi MA. Clinical and paraclinical findings related to the rupture of hydatid cyst into the liver biliary ducts. J Isfahan Med Sch 2008; 26(90): 217-24. [In Persian].
  13. Gomez IG, Lopez-Andujar R, Belda IT, Ramia Angel JM, Moya HA, Orbis CF, et al. Review of the treatment of liver hydatid cysts. World J Gastroenterol 2015; 21(1): 124-31.
  14. Aktan AO, Yalin R. Preoperative albendazole treatment for liver hydatid disease decreases the viability of the cyst. Eur J Gastroenterol Hepatol 1996; 8(9): 877-9.
  15. Bedioui H, Bouslama K, Maghrebi H, Farah J, Ayari H, Hsairi H, et al. Predictive factors of morbidity after surgical treatment of hepatic hydatid cyst. Pan Afr Med J 2012; 13: 29.
Journal of Isfahan Medical School
Volume 37, Issue 516 - Serial Number 516
January and February 2019
Pages 114-118

Files

History

  • Receive Date: 08 January 2019
  • Revise Date: 02 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics