title: Endoscopic therapy of hepatic hydatid cyst disease in preoperative and postoperative settings.
abstract: The most common and serious complication of hepatic hydatid cyst disease is the communication between the cyst and the biliary tree. The diagnosis and treatment of this condition poses various difficulties. Data from patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for hydatid cysts communicating with the bile ducts either in the preoperative or postoperative setting over a 2-year period have been analyzed. In the preoperative group (n=41), jaundice (n=18), biliary colic (n=11), and cholangitis (n=10) were the most common presentations. On the other hand, the most common indication for ERCP in the postoperative group (n=69) was biliocutaneous leaks (n=60) and cholangitis (n=9). All but 2 patients in the preoperative group were treated by endoscopic sphincterotomy and/or extraction of hydatid cyst remnants followed by the placement of nasobiliary drainage catheter for the patients who had filling defects on cholangiogram. Subsequently, these patients were referred for surgery. ERCP was a definitive treatment for the remaining 2 patients. Endotherapy was successful for the patients who developed leak or had cyst remnants following surgery, whereas long-term biliary stenting was required for those who developed bile duct stenosis. There was no ERCP-associated complication, except mild pancreatitis in a single patient and self-limited hemorrhage in 2 patients. ERCP is an efficacious and safe method for the diagnosis and management of biliary complications associated with hydatid cyst disease.
authors.affiliation: Department of Gastroenterology, Yuksek Ihtisas Hospital, Sihhiye, Ankara 06100, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Cicek
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.forename: Selcuk
authors.initials: S
authors.lastname: Disibeyaz
authors.forename: Dilek
authors.initials: D
authors.lastname: Oguz
authors.forename: Cem
authors.initials: C
authors.lastname: Cengiz
authors.forename: Burhan
authors.initials: B
authors.lastname: Sahin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects