title: Value of cyst localization to predict cystobiliary communication in patients undergoing conservative surgery with hydatid cyst.
abstract: OBJECTIVE
  The objectives of this study were to investigate the relationship between the segmental localization of liver hydatid cyst by computed tomography (CT) and the presence of cystobiliary communication (CBC) and to identify the risk factors for CBC.
  
  
  METHODS
  One hundred and eleven of 163 patients who underwent liver hydatid surgery between January 2011 and September 2014 were included in this study and analyzed retrospectively. The size, number, stage, and segmental and lobar localization of the cysts were investigated by CT. The presence of CBC and preoperative laboratory findings were recorded from operation notes.
  
  
  RESULTS
  CBC was more frequent in single large cysts. CBC was most commonly detected in segment 1 (50%), 8 (48.3%), 7 (41.2%), and 4 (40%). CBC was more frequent in the right lobe (40.4%) and Gharbi stage 3 (41.8%) and 4 (55.6%) lesions. There were no differences in CBC according to distance from the hilus. In addition, preoperative total bilirubin, direct bilirubin, alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) elevations were associated with higher CBC frequency (P<0.05). Cyst diameter, number of cysts, and ALP and GGT elevations were independent predictors of CBC presence.
  
  
  CONCLUSIONS
  The evaluation of hydatid cyst diameter, morphological stage, and segmental and lobar localization by abdominal CT and measurement of preoperative cyst diameter, number of cysts, and ALP and GGT values may predict the presence of CBC.
authors.affiliation: Department of Radiology, Dicle University, Diyarbakır, Turkey.
authors.forename: Bircan
authors.initials: B
authors.lastname: Alan
authors.affiliation: Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kapan
authors.affiliation: Department of Radiology, Dicle University, Diyarbakır, Turkey.
authors.forename: Memik
authors.initials: M
authors.lastname: Teke
authors.affiliation: Department of Radiology, Dicle University, Diyarbakır, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Hattapoğlu
authors.affiliation: Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Zülfü
authors.initials: Z
authors.lastname: Arıkanoğlu
keywords: computed tomography; cystobiliary communication; hydatid cyst; hydatid cyst localization