[Surgical treatment of biliary cystic fistula caused by hydatic cysts. Apropos of 83 cases].
The high number of BCF (10-24%) diseases with its direct link on post-surgical casualties require a very well structured therapy. A study over a period of 17 years on 479 patients, whose age ranged average 37 years, broLen into 52 female et 31 male, shows 83 cases of hydatic livercystis that were aggravated by a BCF. In 23 cases (27.7%) the BCF was large, minimal in 60 cases (72.3%) and for 72% the multivesicular hydatic cystis was altered by a pericystis, often sclerous and calcified. In 9 cases (11%) the main biliary duct was enlarged and showed hydatic remains. 3 patients were under radical treatment (3.6%), 2 (2.45%) underwent a total pericystectomy, and 1 (1.2%) a partial pericystectomy. The 80 other patients went through a saving approach treatment which involved. In 44 cases (55%) a flattening with a simple suture of BCF, in 11 cases (13.75%) a suture combined with an external bile drainage, in 5 cases (6.25%) a suture combined with an epiploic-plastic surgery, in 5 cases (6.25%) the suture was combined with the padding of the residual cavity, in 4 cases (5%) the epiploic plastic surgery was combined with an external bile drainage. In 7 cases (8.75%) a bipolar drainage was used and in 4 cases (5%) there was mobile drainage. For 50% of these patients the post surgical surgery was very simple; the most important aggravations were 12 FBK, 8 subphrenic abscess, 1 choleperitonitis. The average length of stay was 23 days. No death was accounted for. The aim was to assess the different technics proposed in the treatment of BCF and elaborate a therapeutical strategy.
Bouzidi
A
A
Service de Chirurgie Viscérale, CHU-Ibn Rochd, Casablanca, Maroc.
Chehab
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003663:Decision Trees; D004322:Drainage / Q000379:methods; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography