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During the last 20 years, 265 patients underwent surgery for liver echinococcosis. Forty-five (17%) had frank ruPture of the hydatid cyst into the intrahepatic bile ducts. The most common clinical manifestations were colicky right hypochondrial pain and obstructiVe jaundice accompanied by fever and chills. A correct preoperative diagnosis was made in 35 patients, based mainly on the history, clinical manifestations, and laboratory findings. In the remaining 10 patients, the diagnosis was established at OPeration. The parasitic cyst was removed and the common bile duct explored in a!l patients. The latter was usually drained with a T-tub~, except for 3 patients in whom a choledochoduodenostomy was performed. The residual cyst cavity was drained in most patients with a Pezzer catheter and closed following partial pericystectomy. Our resuits were satisfactory. There was only 1 death due to sup. purative cholangitis.

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