title: Treatment of hepatic hydatid disease complications using endoscopic retrograde cholangiopancreatography procedures.
abstract: BACKGROUND
  Liver hydatidosis may lead to serious morbidity due to biliary complications, the management for which endoscopic sphincterotomy (ES) and biliary drainage are very efficient. We evaluated the effectiveness of endoscopic treatment for complications of hepatic hydatid disease.
  
  
  METHODS
  We retrospectively reviewed endoscopic retrograde cholangiopancreatography (ERCP) procedures performed between January 2000 and December 2009 and compared laboratory findings, localization of the lesions and ERCP procedures applied between patients with and without jaundice.
  
  
  RESULTS
  In all, 70 ERCP procedures were performed in 54 patients (24 men, 30 women). Of the 70 procedures, 24 were performed to treat jaundice. All patients with biliary fistulas and jaundice were managed with endoscopic procedures. The 70 ERCP procedures included sphincterotomy only (n = 40); sphincterotomy and stent placement (n = 7); stent placement only (n = 4); sphincterotomy and membrane extraction (n = 9); sphincterotomy, membrane extraction and pus drainage (n = 5); and sphincterotomy and pus drainage (n = 5). Laboratory results improved in 3-7 days, and bile leakage ceased in 2-21 days.
  
  
  CONCLUSIONS
  Endoscopic retrograde cholangiopancreatography is a safe and effective way to manage biliary complications of hepatic echinococcal disease. In most patients, ES is the most efficient treatment of postoperative external biliary fistulas, jaundice and accompanying cholangitis, as it enables clearing the bile ducts of hydatid remnants; ES should be performed since it accelerates the healing process by decreasing pressure in the choledochus.
authors.affiliation: Taksim Training and Research Hospital, General Surgery Clinic, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akaydin
authors.forename: Fazilet
authors.initials: F
authors.lastname: Erozgen
authors.forename: Yeliz E
authors.initials: YE
authors.lastname: Ersoy
authors.forename: Selim
authors.initials: S
authors.lastname: Birol
authors.forename: Rafet
authors.initials: R
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D002761:Cholangitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D015331:Cohort Studies; D004444:Echinococcosis, Hepatic / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects / Q000379:methods; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult