Journal of Research and Development
Open Access

Abstract

Management of Postoperative Biliary Fistula After Hydatid Liver Surgery: Are There Any Differences between Localizations?

Gokhan A, Ali K, Bora K, Soykan A, Mustafa K, Emin G, Halil A, Servet K, Sebahattin Celik and Özgür K

Objectives

The most common complication of hepatic hydatid cysts is the intra-biliary rupture seen approximately in 10-30% of patients. This complication mainly seen in the centrally localized, large hydatid cyst operations. The aim of this study is to compare managements of postoperative biliary fistula after hydatid liver surgery, according to localization of hepatic cyst.

Method

A total of 156 patients who underwent surgery for hydatid cyst localized to the liver and presented with persistent drainage of bile from drain after surgical intervention, were included in this prospective study. All the patients were done ERCP procedure because of external biliary fistula after hydatid liver surgery. Patients divided in two groups according to cyst localization in liver. Group 1 (n=96) right side localized cysts, group 2 (n=60) left side-localized group.

Results

Closure time of the external biliary fistula was significant differences between group 1 and group 2 (19 days in group 1 and 25 days in group 2, p<0.05). Mean daily fistula output was 294cc (range 100-800 cc) in Group 1, 351 cc (range 200-1000 cc) in Group 2, respectively. The daily fistula output was higher in group 2 than in group 1 p<0.05. In group 1 multiple cysts was more than in group 2.

Conclusions

We suggest to perform earlier ERCP procedure, if localization of hydatid cyst is in the central and fistula output is >300 ml/day. The left lobe located hydatid cysts with external biliary fistula take more time to close than those located in the right lobe.