Endoscopic management of hepatic hydatid cyst with biliary communication

Sharma, Barjesh Chander; Reddy, Ravisankar; Garg, Vishal

doi:10.1111/j.1443-1661.2011.01225.x

Cited by 22 publications

(12 citation statements)

References 15 publications

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“…However, many other researchers have recommended using biliary prostheses in addition to ES for a couple of days to weeks [28, 29, 30]. Adas et al and Akçakaya et al demonstrated that using biliary stent or NBD in conjunction with ES improved treatment success when biliary strictures or choledocolithiasis accompanied high-output fistulas [28, 30].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Endoscopic Treatment Outcomes in patients with Postoperative Bile Leakage

Sayar

Ölmez

Avcıoğlu³

et al. 2016

North Clin Istanbul

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OBJECTIVE:Bile leakage, while rare, can be a complication seen after cholecystectomy. It may also occur after hepatic or biliary surgical procedures. Etiology may be underlying pathology or surgical complication. Endoscopic retrograde cholangiopancreatography (ERCP) can play major role in diagnosis and treatment of bile leakage. Present study was a retrospective analysis of outcomes of ERCP procedure in patients with bile leakage.METHODS:Patients who underwent ERCP for bile leakage after surgery between 2008 and 2012 were included in the study. Etiology, clinical and radiological characteristics, and endoscopic treatment outcomes were recorded and analyzed.RESULTS:Total of 31 patients (10 male, 21 female) were included in the study. ERCP was performed for bile leakage after cholecystectomy in 20 patients, after hydatid cyst operation in 10 patients, and after hepatic resection in 1 patient. Clinical signs and symptoms of bile leakage included abdominal pain, bile drainage from percutaneous drain, peritonitis, jaundice, and bilioma. Twelve (60%) patients were treated with endoscopic sphincterotomy (ES) and nasobiliary drainage (NBD) catheter, 7 patients (35%) were treated with ES and biliary stent (BS), and 1 patient (5%) was treated with ES alone. Treatment efficiency was 100% in bile leakage cases after cholecystectomy. Ten (32%) cases of hydatid cyst surgery had subsequent cystobiliary fistula. Of these patients, 7 were treated with ES and NBD, 2 were treated with ES and BS, and 1 patient (8%) with ES alone. Treatment was successful in 90% of these cases.CONCLUSION:ERCP is an effective method to diagnose and treat bile leakage. Endoscopic treatment of postoperative bile leakage should be individualized based on etiological and other factors, such as accompanying fistula.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Endoscopic Treatment Outcomes in patients with Postoperative Bile Leakage

Sayar

Ölmez

Avcıoğlu³

et al. 2016

North Clin Istanbul

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“…21 In another prospective study conducted by Sharma et al on patients with a hydatid cyst communicating with the bile duct, sphincterotomy with insertion of a nasobiliary drain (n = 6) or sphincterotomy with biliary stenting (n = 22) led to fistula healing in all patients after a median period of 11 (range, 5-45) days. 22 The removal of nasobiliary drainage catheters and stents was performed 8-45 days after stent placement. 22 Patients who were diagnosed with bile leak intraoperatively during cholecystectomy or those suspected with biliary injury should immediately undergo drain placement and ERCP.…”

Section: Staymentioning

confidence: 99%

“…22 The removal of nasobiliary drainage catheters and stents was performed 8-45 days after stent placement. 22 Patients who were diagnosed with bile leak intraoperatively during cholecystectomy or those suspected with biliary injury should immediately undergo drain placement and ERCP. However, our analysis did not show any significant difference in the outcome in relation to the timing of ERCP after the onset of bile leak between the two groups.…”

Section: Staymentioning

confidence: 99%

Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center

et al. 2020

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The International Study Group of Liver Surgery has defined bile duct leak (BDL) as "fluid with an increased bilirubin concentration in the abdominal drain or in the intra-abdominal fluid or as the need for radiologic intervention because of bil-iary fluid collection or re-laparotomy resulting from bile peritonitis". 1 Bile leak is commonly associated with surgeries (such as cholecystectomy, liver transplantation, partial hepatectomy, and hydatid cyst excision). However, it may also occur secondary to various necro-inflammatory conditions involving the liver. The most frequent cause of bile leak is iatrogenic, and cholecystectomy is the most common procedure associated with this condition. Bile leak occurs in 0.1%-0.5% of patients who underwent open cholecystectomy. 2,3 Approximately 0.5%-2% of patients who underwent laparoscopic cholecystectomy can develop bile leak, with the majority arising from the cystic duct stump. 4-6 The clinical presentation of bile leak varies from asymptomatic drainage of bile to life-threatening conditions including biliary peritonitis. Thus, bile leak can be associated with significant morbidity and can lead to death if left untreated. The communication between the biliary tree and amoebic liver abscess is observed in up to 27% of cases, and it commonly presents with jaundice and has a longer duration. 7 In

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“…The liver is the most frequently affected organ in echinococcosis [ 1 ]. A common and severe complication in hepatic hydatid cyst disease is the communication between the cyst and the biliary tree [ 2 ]. However, fistulization between gallbladder and hydatid cyst is rare.…”

Section: Introductionmentioning

confidence: 99%

Cholecysto-Hydatid Cyst Fistula: A Rare Cause of Cholangitis

Kırmacı

Akay²,

Özgül

et al. 2020

Am J Case Rep

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Patient: Female, 76-year-old Final Diagnosis: Left hepatic cyst hidatic fistula to gall bladder Symptoms: Biliary colic • icterus • Sepsis Medication: — Clinical Procedure: Multidiscipliner treatment Specialty: Surgery Objective: Rare disease Background: Cholecysto-hydatid fistula is a rare complication of liver echinococcosis; suppurative cholangitis due to cholecysto-hydatid fistula is even rarer. A multidisciplinary approach is required by radiology and surgery departments during the preoperative diagnosis and treatment processes of these cases. In this paper, a patient treated with suppurative cholangitis due to cholecysto-hydatid fistula is presented. Case Report: A 76-year-old female patient was admitted to emergency services due to cholangitis. Abdominal computerized tomography (CT) examination revealed that the common bile duct was dilated through the right liver in a wide and torsional pattern; the gallbladder cleaved into hepatic flexura and its wall became irregular. There was a cystic appearance 10×13×12 cm in size on the lateral segment of the left liver lobe. Endoscopic retrograde cholangiopancreatography (ERCP) was performed, and it showed the communication between the hydatid cyst pouch and the bile duct. The patient was taken to open surgery, which confirmed the imaging findings. The gallbladder and the adjacent cyst were excised, and a T-tube was placed in the choledochus. Postoperative recovery was uneventful. Conclusions: We suggest that cholecysto-hydatid fistula is a severe problem that requires close workup with both the radiology and surgery departments. Preoperative ERCP is beneficial for the visualization of the fistulization between gallbladder and hydatid cyst and for the treatment of suppurative cholangitis.

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Endoscopic management of hepatic hydatid cyst with biliary communication

Abstract: Endoscopic therapy is an effective mode of treatment for biliary fistulas complicating hepatic hydatid cyst.

Cited by 22 publications

References 15 publications

A Retrospective Analysis of Endoscopic Treatment Outcomes in patients with Postoperative Bile Leakage

A Retrospective Analysis of Endoscopic Treatment Outcomes in patients with Postoperative Bile Leakage

Outcomes of Endoscopic Management among Patients with Bile Leak of Various Etiologies at a Tertiary Care Center

Cholecysto-Hydatid Cyst Fistula: A Rare Cause of Cholangitis

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