title: Factors predictive of frank intrabiliary rupture in patients with hepatic hydatid cysts.
abstract: OBJECTIVE
  Frank intrabiliary rupture (IBR) is a serious complication that occurs in 3-17% of patients. The aim of this study was to identify independent predictors of frank IBR of hepatic hydatid cysts (HHC).
  
  
  METHODS
  Some 741 patients with HHC underwent surgery for HHC between 1965 and 2000. Patient and cyst characteristics were subjected to univariate and multivariate analysis to identify independent predictors of frank IBR.
  
  
  RESULTS
  Frank IBR was associated with significantly older age (median, 41 vs. 37 years,p =0.025), more male subjects (40% vs. 32%, p = 0.024), longer duration of symptoms (16 vs. 6 months, p < 0.001), larger cysts (median, 12 vs. 9cm, p < 0.001) and higher incidence of solitary (86% vs. 62%, p < 0.001), multivesicular (89% vs. 39%, p < 0.001), left lobar (38% vs. 13%, p < 0.001) and infected cysts (78% vs. 24%, p < 0.001). Multivariate analysis identified cyst size (> or =10 cm), cyst infection, multivesicular content, solitary cysts and location in the left lobe of liver as well as long duration of symptoms as independent predictors of frank IBR.
  
  
  CONCLUSIONS
  Patients with large (> or =10 cm), multivesicular, solitary, left lobar or infected HHC as well as those with prolonged history are at increased risk of frank IBR and should be offered early surgery.
authors.affiliation: Department of Surgery, Medical City Teaching Hospital, Baghdad, Iraq.
authors.forename: Ahmed Z
authors.initials: AZ
authors.lastname: Al-Bahrani
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Maiyah
authors.forename: Basil J
authors.initials: BJ
authors.lastname: Ammori
authors.forename: Zuhair R
authors.initials: ZR
authors.lastname: Al-Bahrani
mesh_terms: D000328:Adult; D001658:Biliary Fistula / Q000209:etiology*; D004444:Echinococcosis, Hepatic / Q000150:complications*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012422:Rupture, Spontaneous