title: The use of ERCP in the study of patients with hepatic echinococcosis before and after surgical intervention.
abstract: BACKGROUND
  Biliary tree involvement is the most common complication of hydatid liver disease, which is difficult to detect and manage.
  
  
  METHODS
  During the last 7 years, we examined by ERCP 26 cases with echinococcal liver involvement. Indications in the preoperative group included cholangitis in 6 cases, right-sided hypochondralgia involving 4, preoperative assessment in 4, and icterus in 1 case. In the postoperative group, the indications for ERCP were cholangitis in 5 cases, external biliary fistulas in 5, and biliary colic in 1 case.
  
  
  RESULTS
  ERCP findings in the preoperative group included external bile duct compression in 11 cases (73.3%), biliary fistula affecting 3 (20%), and echinococcal remnants within the common bile duct in 1 case (6.6%). With regard to the postoperative group, biliary fistula formation was detected in 6 cases (54.5%), echinococcal remnants within the common bile duct in 4 (36.3%), and external bile duct compression involving 1 case (9%). Endoscopic sphincterotomy was successfully performed in 13 patients in both groups. No serious complications were encountered.
  
  
  CONCLUSIONS
  ERCP is a safe and helpful preoperative or postoperative tool that aids in the diagnosis and often the treatment of echinococcal liver disease with involvement of the bile ducts.
authors.affiliation: Department of Gastroenterology, General Hospital of Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Spiliadis
authors.forename: S
authors.initials: S
authors.lastname: Georgopoulos
authors.forename: A
authors.initials: A
authors.lastname: Dailianas
authors.forename: A
authors.initials: A
authors.lastname: Konstantinidis
authors.forename: M
authors.initials: M
authors.lastname: Rimikis
authors.forename: N
authors.initials: N
authors.lastname: Skandalis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000469:parasitology; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D003135:Common Bile Duct / Q000000981:diagnostic imaging*; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000379:methods