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Comparative Study
. 2012 Aug;55(4):244-8.
doi: 10.1503/cjs.036010.

Treatment of hepatic hydatid disease complications using endoscopic retrograde cholangiopancreatography procedures

Murat Akaydin  1 , Fazilet Erozgen, Yeliz E Ersoy, Selim Birol, Rafet Kaplan
Affiliations
Comparative Study

Treatment of hepatic hydatid disease complications using endoscopic retrograde cholangiopancreatography procedures

Murat Akaydin et al. Can J Surg. 2012 Aug.

Abstract
in English, French

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.

Conclusion: 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.

Contexte: L’hydatidose hépatique peut causer une morbidité grave à cause de complications biliaires. La sphinctérotomie par endoscopie (SE) et le drainage biliaire sont des méthodes très efficaces de prise en charge. Nous avons évalué l’efficacité du traitement endoscopique des complications de l’hydatidose hépatique.

Méthodes: Nous avons analysé rétrospectivement les cholangiopancréatographies rétrogrades endoscopiques (CPRE) pratiquées entre janvier 2000 et décembre 2009 et comparé les résultats de laboratoire, la localisation des lésions et les CPRE pratiquées entre les patients qui avaient la jaunisse et ceux ne l’avaient pas.

Résultats: Au total, 70 CPRE ont été pratiquées sur 54 patients (24 hommes, 30 femmes). Sur les 70 interventions, 24 visaient à traiter la jaunisse. Tous les patients qui avaient des fistules biliaires et la jaunisse ont été traités par endoscopie. Les 70 CPRE comprenaient la sphinctérotomie seulement (n = 40); la sphinctérotomie et la mise en place d’un stent (n = 7); la mise en place d’un stent seulement (n = 4); la sphinctérotomie et l’extraction de la membrane (n = 9); la sphinctérotomie, l’extraction de la membrane et le drainage du pus (n = 5); et la sphinctérotomie et le drainage du pus (n = 5). Les résultats de laboratoire se sont améliorés en 3 à 7 jours et l’écoulement de la bile a cessé en 2 à 21 jours.

Conclusion: La cholangiopancréatographie rétrograde endoscopique est une façon sécuritaire et efficace de prendre en charge les complications biliaires de l’échinococcose hépatique. Chez la plupart des patients, la SE constitue le traitement le plus efficace des fistules biliaires externes postopératoires, de la jaunisse et de la cholangite connexe, car elle permet de nettoyer les canaux biliaires des résidus hydatiques. Il faudrait pratiquer la SE puisqu’elle accélère la guérison en réduisant la pression exercée sur le cholédoque.

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Figures

Fig. 1
Fig. 1
(A) Appearance of hydatid disease of the liver on a computed tomography scan. Endoscopic retrograde cholangiopancreatography view of (B) the hydatid material in the common bile duct, (C) contrast extravasation from the intrahepatic bile ducts to the hydatid cyst cavity, (D) infected hydatid material drained after papillotomy, (E) balloon extraction of the hydatid material after papillotomy and (F) extraction of the germinative membrane from the choledochus.
See this image and copyright information in PMC

References

    1. Sayek I, Yalin R, Sanaç Y. Surgical treatment of hydatid disease of the liver. Arch Surg. 1980;115:847–50. - PubMed
    1. Alper A, Ariogul O, Emre A, et al. Choledochoduodenostomy for intrabiliary rupture of hydatid cysts of liver. Br J Surg. 1987;74:243–5. - PubMed
    1. Ismail K, Gokcora IH, Ormeci N. Surgical treatment of hydatid cysts of the pancreas. Int Surg. 1991;76:185–8. - PubMed
    1. Taylor BR, Langer B. Current surgical management of hepatic cyst disease. Adv Surg. 1997;31:127–48. - PubMed
    1. Akhan O, Ozmen MN, Dinçer A, et al. Liver hydatid disease: long-term results of percutaneous treatment. Radiology. 1996;198:259–64. - PubMed

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