Endoscopic retrograde cholangiopancreatography in ruptured liver hydatid cyst.
One of the most common and serious complications of hepatic hydatid cyst disease is communication between the cyst and the biliary tree. Surgical management of biliary fistula is associated with high morbidity and mortality. We retrospectively reviewed the effectiveness of endoscopic treatment of ruptured hydatid cyst into intrahepatic bile ducts. Diagnosis of intrabiliary rupture of hydatid cyst was mostly suspected by acute cholangitis, jaundice, pain, and/or persistent external biliary fistula after surgery. The diagnosis was confirmed by radiology and endoscopic retrograde cholangiopancreatography (ERCP) findings. We retrospectively reviewed clinical, laboratory, imagery, and ERCP findings for all patients. The therapeutic methods performed were endoscopic sphincterotomy, extraction by balloon or Dormia basket, stenting, or nasobiliary drainage. Sixteen patients with ruptured hepatic hydatid cyst into bile ducts were seen in 9 years. Nine of 16 patients had a surgical history of hepatic hydatid cyst and three patients had a percutanous treatment history. We carried out ERCP with sphincterotomy and extraction of hydatid materials (extraction balloon n = 11; Dormia basket n = 5) or biliary drainage (nasobiliary drainage n = 1; biliary stenting n = 1). The fistula healed in 80 % of patients with a median time of 6 weeks [range, 1-12] after endoscopic treatment. ERCP was an effective method of treatment for hepatic hydatid cyst with biliary fistula.
Department of Gastroenterology C, Ibn Sina Hospital, University Mohammed Vth, Rabat, Morocco. borahmamed@gmail.com.
Mohamed
M
Borahma
Department of Gastroenterology C, Ibn Sina Hospital, University Mohammed Vth, Rabat, Morocco.
Rajaa
R
Afifi
Department of Gastroenterology C, Ibn Sina Hospital, University Mohammed Vth, Rabat, Morocco.
Imane
I
Benelbarhdadi
Department of Gastroenterology C, Ibn Sina Hospital, University Mohammed Vth, Rabat, Morocco.
Fatima Zahra
FZ
Ajana
Department of Gastroenterology C, Ibn Sina Hospital, University Mohammed Vth, Rabat, Morocco.
Wafaa
W
Essamri
Department of Gastroenterology C, Ibn Sina Hospital, University Mohammed Vth, Rabat, Morocco.
Abdellah
A
Essaid
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage / Q000379:methods; D004444:Echinococcosis, Hepatic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D016717:Sphincterotomy, Endoscopic; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult
Endoscopic retrograde cholangiopancreatography; Hydatid cyst; Intrabiliary rupture