title: Cystobiliary communication in hepatic hydatid cyst: predictors and outcome.
abstract: OBJECTIVE
  Cystobiliary communication (CBF) with hepatic hydatid disease is responsible for postoperative bile leakage after surgical management. This study aims to detect various predictors of CBF and its outcome after surgical management.
  
  
  METHODS
  This is a retrospective, cohort study of all patients who underwent surgical management for hydatid disease of the liver. Patient data were recorded on an internal web-based registry system supplemented by paper records. Patients were classified into two groups according to the presence of CBF: group (A) patients with CBF and group (B) patients without CBF.
  
  
  RESULTS
  There were 123 patients with a hepatic hydatid cyst with a mean age of 39.92±14.59 years. Patients were classified into group (A), 26 patients (21.1%) with CBF, and group (B), 97 patients (78.9%) without CBF. The age group (p=0.04), presence of jaundice (p=0.001), serum glutamic-pyruvic transaminase (SGPT) (p=0.001), cyst size (p=0.0001), and cyst size group (>10 cm) (p=0.0001) were associated with CBF. That cyst size was the only independent predictor of the occurrence of CBF. Intraoperative suturing and the T tube led to complete healing of CBF, and postoperative endoscopic retrograde cholangio-pancreatography (ERCP) and tubal drainage led to a rapid reduction in the bile output and the healing of the fistulas after 9±2.6 days.
  
  
  CONCLUSIONS
  That cyst size was the only independent predictor for the occurrence of CBF. Management is related to the size of the fistula, the site of the cyst, and the experience of the hepatobiliary surgeon. ERCP is an important option for the management of CBF.
authors.affiliation: Gastroenterology Surgical Center, Mansoura University, Governorate, Egypt. elnakeebayman@yahoo.com.
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.forename: Ali
authors.initials: A
authors.lastname: Salem
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sorogy
authors.forename: Youssef
authors.initials: Y
authors.lastname: Mahdy
authors.forename: Mohamed Abd
authors.initials: MA
authors.lastname: Ellatif
authors.forename: Ahmed
authors.initials: A
authors.lastname: Moneer
authors.forename: Rami
authors.initials: R
authors.lastname: Said
authors.forename: Ahmed
authors.initials: A
authors.lastname: El Ghawalby
authors.forename: Helmy
authors.initials: H
authors.lastname: Ezzat
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001646:Bile / Q000378:metabolism; D001658:Biliary Fistula / Q000209:etiology* / Q000601:surgery; D001660:Biliary Tract Diseases / Q000209:etiology* / Q000601:surgery; D016022:Case-Control Studies; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D004322:Drainage / Q000379:methods; D004444:Echinococcosis, Hepatic / Q000097:blood / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000410:Alanine Transaminase