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Biliary complications after hydatid liver surgery: Incidence and risk factors

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Journal of Gastrointestinal Surgery

Abstract

The aims of this study were to determine the incidence and risk factors of biliary leakage and biliary fistu lae after hydatid liver surgery and to suggest preventive precautions. From January 1999 to June 2000, 70 cysts were examined from 54 patients who were operated on for hydatid liver disease. Age, sex, primary or recurrent disease, liver function tests, number, location, content, radiological type, and diameter and cav ity management techniques were examined with univariate and multivariate analyses for biliary complica tions. Biliary leakage occurred in 14 cysts (26%) from the patients. Purulent and/or bilious cyst content (61.9% vs. 2.0%; P = 0.022), male gender (40.9% vs. 10.4%; P = 0.038), and pre-operative raised alka line phosphatase and gamma glutamyl transferase levels (34.6% vs. 11.4%; P = 0.047) were found as in dependent risk factors for post-operative biliary leakage. Nine instances of biliary leakage (16.7%) closed spontaneously within seven days. The remaining five instances of biliary leakage (9.3%) persisted for more than 10 days and were accepted as biliary fistulae. Stepwise logistic regression identified cyst con tent was the only risk factor for biliary fistulae (19% vs. 2%; P = 0.036). Described risk factors for post operative biliary complications after hydatid liver surgery may be the guidelines for additional pre-opera tive or intra-operative radiological interventions of the biliary tract and for preventive procedures such as surgical biliary drainage.

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References

  1. Medical statistics of Turkish Ministery of Health, 1994.

  2. Ozmen V, Igci A, Kebudi A, Kecer M, Bozfakioglu Y, Parlak M. Surgical treatment of hepatic hydatid disease. Can J Surg 1992;35:423–427.

    PubMed  CAS  Google Scholar 

  3. Langer JC, Rose DB, Keystone JS, Taylor BR, Langer B. Diagnosis and management of hydatid disease of the liver. A 15-year North American experience. Ann Surg 1984;199:412–417.

    Article  PubMed  CAS  Google Scholar 

  4. Demirci S, Eraslan S, Anadol E. Comparison of the results of different surgical techniques in the management of hydatid cyst of the liver. World J Surg 1989; 13:88–90.

    Article  PubMed  CAS  Google Scholar 

  5. DawsonJL, Stamatakis JD, Stringer MD, Williams R. Surgical treatment of hepatic hydatid disease. Br J Surg 1988;75:946–950.

    Article  Google Scholar 

  6. Dziri C, PaquetJC, HayJM, Fingerhut A, Msika S, Zeitoun G, Sastre B, Khalfallah T, French Associations for Surgical Research. Omentoplasty in the preventation of deep abdominal complications after surgery for hydatid disease of the liver: A multicenter, prospective, randomized trial. J Am Coll Surg 1999;188:281–289.

    Article  PubMed  CAS  Google Scholar 

  7. Ariogul O, Emre A, Alper A, Uras A. Introflexion as a method of surgical treatment for hydatid disease. Surg Gynecol Obstet 1989;169:356–358.

    PubMed  CAS  Google Scholar 

  8. Rakas FS, El-Mufti M, Abuthina H, Challeni CR. Omentoplasty or tube drainage for the management of the residual cavity following the removal of a hepatic hydatid cyst. Hepatogastroenterology 1990;37(Suppl_2):55–57.

    PubMed  Google Scholar 

  9. Gharbi HA, Hassine W, Brauner MW, Dupuch K. Ultrasound examination of the hydatid liver. Radiology 1981; 139:459–463.

    PubMed  CAS  Google Scholar 

  10. Weirich WL. Hydatid disease of the liver. Am J Surg 1979;138:805–808.

    Article  PubMed  CAS  Google Scholar 

  11. Karavias DD, Vagianos CE, Bouboulis N, Rathosis S, Androulakis J. Improved techniques in the surgical treatmant of hepatic hydatidosis. Surgery 1992; 174:176–180.

    CAS  Google Scholar 

  12. Brodsky A, Matter I, Sabo E, Cohen A, Abrahamson J, Eldar S. Laparoscopic cholecystectomy for acute cholecystitis: Can the need for conversion and the probability of complications be predicted? A prospective study. Surg Endosc 2000;14:755–760.

    Article  PubMed  CAS  Google Scholar 

  13. Ziser A, Plevak DJ, Wiesner RH, Rakela J, Offord KP, Brown DL. Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery. Anesthesiology 1999;90:42–53.

    Article  PubMed  CAS  Google Scholar 

  14. Cohen MM, Duncan PG, Tate RB. Does anesthesia contribute to operative mortality? JAMA 1988;260:2859–2863.

    Article  PubMed  CAS  Google Scholar 

  15. Little JM, Hollands MJ, Ekberg H. Recurrence of hydatid disease. World J Surg 1988;12:700–704.

    Article  PubMed  CAS  Google Scholar 

  16. Safioleas M, Misiakos E, Manti C, Katsikas D, Skalkeas G. Diagnostic evaluation and surgical management of hydatid disease of the liver. World J Surg 1994;18:859–865.

    Article  PubMed  CAS  Google Scholar 

  17. Sayek I, Onat D. Diagnosis and treatment of uncomplicated hydatid cysts of the liver. World J Surg 2001;25:21–27.

    Article  PubMed  CAS  Google Scholar 

  18. Aarons BJ, Fitzpatrick SC. Hepato-biliary hydatid disease. In: Kune GA, Sali A, eds. The practice of biliary surgery. Oxford: Blackwell Scientific Publication, 1980, pp 399–416.

    Google Scholar 

  19. SayekI, Yalin R, Sanac Y. Surgical treatment of hydatid disease of the liver. Arch Surg 1980; 115:847–850.

    Google Scholar 

  20. Magistrelli P, Masetti R, Coppola R, Costamagna G, Durastante V, Nuzzo G, Picciocchi A. Value of ERCP in the diagnosis and management of pre- and post-operative biliary complications in hydatid disease of the liver. Gastrointest Radiol 1989; 14:315–320.

    Article  PubMed  CAS  Google Scholar 

  21. Gahukamble DB, Khamage AS, elGadi M, Shatwan F. An effective and safe surgical method for the treatment of hydatid cysts of the liver in children. Trop Geogr Med 1991; 43:7–11.

    PubMed  CAS  Google Scholar 

  22. Barros JL. Hydatid disease of the liver. Am J Surg 1978; 135:597–600.

    Article  PubMed  CAS  Google Scholar 

  23. Abu Zeid M, El-Eibiedy G, Abu-El-Eininen A, Gad El-Hak N, Abd El-Wahab M, Azzat F. Surgical treatment of hepatic hydatid disease. Hepatogastroenterology 1998;45:1802–1806

    Google Scholar 

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Correspondence to Cuneyt Kayaalp M.D..

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Kayaalp, C., Bzeizi, K., Demirbag, A.E. et al. Biliary complications after hydatid liver surgery: Incidence and risk factors. J Gastrointest Surg 6, 706–712 (2002). https://doi.org/10.1016/S1091-255X(02)00046-X

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  • DOI: https://doi.org/10.1016/S1091-255X(02)00046-X

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