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Management of liver hydatid cyst with cystobiliary communication and acute cholangitis: a 27-year experience

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Abstract

Purpose

The rupture of the hydatid cyst into the bile ducts is a common and serious complication. The rupture can be latent or revealed after a complication such as acute cholangitis. The objective of this study was to discuss the clinical features, radiographic findings, and surgical treatment of this rare complication.

Methods

A retrospective analysis of patients operated for acute cholangitis caused by hydatid cyst between January 1990 and May 2016 was conducted.

Results

Our study included 55 cases of acute cholangitis caused by ruptured hydatid cyst: 35 were men and 20 were women. Five patients had medical history of hydatid cyst. On imaging, all patients had a dilated bile duct. In 51 cases, there was a single hydatid cyst. Hydatid cysts with fistula were located in the right lobe of the liver in 49 cases and in the left lobe in 6 cases. Seven patients underwent an emergency surgery after admission, while others were operated after 3–8 days. A conservative procedure associated with drainage was applied in 49 cases. Endoscopic treatment was performed in four cases which failed in two cases. Twenty-eight cases developed postoperative complications, among which the most common complication was biliary fistula (n − 17). There were eight cases of postoperative deaths (14.5%).

Conclusions

Liver hydatid cyst with cystobiliary communication and superadded acute cholangitis is a serious clinical problem requiring the early diagnosis and surgery in the absence of endoscopic therapy.

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Authors and Affiliations

  1. Department of Digestive Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia

    Omar Toumi, Houssem Ammar, Sadok Ben Jabra, Faouzi Noomen & Khadija Zouari

  2. Department of Gastrointestinal Sciences, Synergy Institute of Medical Sciences, Dehradun, India

    Rahul Gupta

  3. Department of Radiology, Fattouma Bourguiba Hospital, Monastir, Tunisia

    Badii Hamida & Mondher Golli

Authors
  1. Omar Toumi
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  2. Houssem Ammar
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  3. Rahul Gupta
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  4. Sadok Ben Jabra
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  5. Badii Hamida
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  6. Faouzi Noomen
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  7. Khadija Zouari
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  8. Mondher Golli
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Corresponding author

Correspondence to Omar Toumi.

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Conflict of interest

Omar Toumi, Houssem Ammar, Rahul Gupta, Sadok Ben Jabra, Badii Hamida, Faouzi Noomen, Khadija Zouari, and Mondher Golli have no conflict of interest to declare.

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Toumi, O., Ammar, H., Gupta, R. et al. Management of liver hydatid cyst with cystobiliary communication and acute cholangitis: a 27-year experience. Eur J Trauma Emerg Surg 45, 1115–1119 (2019). https://doi.org/10.1007/s00068-018-0995-7

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  • DOI: https://doi.org/10.1007/s00068-018-0995-7

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