title: Diagnostic and therapeutic ERCP in hepatic hydatid disease.
abstract: BACKGROUND
  This retrospective study evaluated the use of diagnostic and therapeutic ERCP in pre- and postoperative patients with hepatic hydatid disease.
  
  
  METHODS
  For 8 years, ERCP was performed in 39 patients with hepatic echinococcal disease. Indications in the preoperative group of patients (n = 19) included a cholestatic enzyme profile in all cases; jaundice or acute cholangitis also was present in, respectively, 14 and 7 cases. In the postoperative group (n = 20), indications for ERCP included persistent external biliary fistula after surgery in 10 patients, jaundice in 8, acute cholangitis in 7, and right upper quadrant pain in 2 patients.
  
  
  RESULTS
  ERCP findings in the preoperative group included cystobiliary fistula (9 patients), external compression of the hepatic biliary system (5), hydatid vesicles and/or membranes within the biliary tract (3), intrahepatic duct stricture (1), and a normal cholangiogram (4). The most common ERCP finding in the postoperative group was external biliary fistula (10 patients); other findings consisted of hydatid cyst material within the bile duct (4), bile duct stenosis (2), cystobiliary fistula and hydatid cyst material in the bile duct (1), cystobiliary fistula (1), hydatid membranes in the gallbladder (1), extrinsic compression to bile ducts (1), and a normal cholangiogram (1). In the preoperative group, endoscopic sphincterotomy was performed in 11 patients, with balloon catheter extraction in 2; complete resolution of findings was achieved in 10 cases. In the postoperative group, sphincterotomy (with balloon or basket extraction as needed) was performed in 19 patients, stents were placed in 2 patients, 1 patient underwent balloon dilatation, and 1 had nasobiliary drainage; there was complete resolution of the findings in 14 of the 20 patients.
  
  
  CONCLUSIONS
  ERCP and related therapeutic maneuvers are safe and valuable in the pre- and postoperative management of patients with hepatic hydatid disease.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Halis
authors.initials: H
authors.lastname: Simşek
authors.forename: Ersan
authors.initials: E
authors.lastname: Ozaslan
authors.forename: Iskender
authors.initials: I
authors.lastname: Sayek
authors.forename: Cemil
authors.initials: C
authors.lastname: Savaş
authors.forename: Osman
authors.initials: O
authors.lastname: Abbasoğlu
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Soylu
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Balaban
authors.forename: Gonca
authors.initials: G
authors.lastname: Tatar
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011184:Postoperative Period; D011300:Preoperative Care; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome