Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2005; 11(16): 2472-2476
Published online Apr 28, 2005. doi: 10.3748/wjg.v11.i16.2472
Intrabiliary rupture: An algorithm in the treatment of controversial complication of hepatic hydatidosis
Kenan Erzurumlu, Adem Dervisoglu, Cafer Polat, Gokhan Senyurek, Ibrahim Yetim, Murat Hokelek
Kenan Erzurumlu, Adem Dervisoglu, Cafer Polat, Gokhan Senyurek, Ibrahim Yetim, Murat Hokelek, Department of Surgery, Medical School, Ondokuz Mayis University, Kurupelit, Samsun, Turkey
Author contributions: All authors contributed equally to the work.
Correspondence to: Kenan Erzurumlu, MD, Professor, Department of Surgery, Medical School, Ondokuz Mayis University, 55139 Kurupelit, Samsun, Turkey. kerzurum@omu.edu.tr
Telephone: +90-362-4576000-2470 Fax: +90-362-4576029
Received: March 31, 2004
Revised: April 2, 2004
Accepted: May 13, 2004
Published online: April 28, 2005
Abstract

AIM: Intrabiliary rupture (IBR) is a common and serious compli-cation of hepatic hydatid cyst. The incidence varies from 1% to 25%. The treatment of IBR is still controversial. We aimed to design an algorithm for the treatment of hepatic hydatidosis with IBR by reviewing our cases.

METHODS: Eight cases of IBR were analyzed retrospectively. Patients were evaluated according to age, sex, clinical findings, cyst number and stage, abdominal ultrasonography and CT-scan, surgical methods, complica-tions, results and coincidental diseases.

RESULTS: Female/male ratio was 1/7. Mean age was 52.12±18.26 years (range 24-69 years). Right upper quadrant pain, flatulence, palpable hepatic mass were symptoms common in all patients. Cholestatic jaundice was found in four cases. In all patients, cyst evacuation and omento-plasty were performed, followed by either choledochod-uodenostomy, T-tube drainage, intracavitary suturing of the orifice, two cases in each. Whereas in two patients diagnosed post-operatively percutaneous drainage of biliary collection or ERCP and sphincteroplasty were added. Morbidity and hospital stay were higher in these cases.

CONCLUSION: When the diagnosis of IBR can be done pre-or intra-operatively, morbidity decreases. If a biliary fistula is seen post-operatively, endoscopic procedures such as ERCP, sphincteroplasty or nasobiliary drainage can be applied.

Keywords: Intrabiliary rupture, Hepatic hydatidcyst