title: Outcome of minimal surgery for hydatid cysts of the liver in children with reference to post-operative biliary leakage.
abstract: Analysis of 30 children with hydatid cysts of the liver who were treated by partial pericystectomy and external tube drainage showed that five (21%) of 24 cases in whom clear hydatid fluid was observed during surgery developed biliary leakage. The cysts in the remaining six contained bile-stained fluid, indicating the presence of cystobiliary communications, and five of these children continued to drain bile post-operatively, in spite of appropriate precautions taken during surgery. Histological examination of the pericyst wall confirmed the presence of openings of small bile ducts in the cyst which probably caused the biliary leak. It is possible that some larger openings were overlooked during surgery. It is concluded from this study that biliary leakage during the post-operative period should be expected in a significant number of patients subjected to surgery for hydatid cysts of the liver. However, the leak is likely to cease spontaneously, providing distal biliary duct obstruction is ruled out and external tube drainage is used to prevent accumulation of bile in the pericyst cavity.
authors.affiliation: Department of Paediatric Surgery, Faculty of Medicine, Al Arab Medical University, Benghazi, Libya.
authors.forename: D B
authors.initials: DB
authors.lastname: Gahukamble
authors.forename: A S
authors.initials: AS
authors.lastname: Khamage
authors.forename: L D
authors.initials: LD
authors.lastname: Gahukamble
mesh_terms: D000667:Ampicillin / Q000627:therapeutic use; D001646:Bile; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D004444:Echinococcosis, Hepatic / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010406:Penicillins / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010406:Penicillins; D000667:Ampicillin