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Biliary complications of hydatid cyst, surgical management

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Cystic echinoccocosis is a zoonose with hepatic involvement. It determines the formation of a tumor like cyst, with silent evolution, that is either discovered by accident in early stages or after local or systemic complications, such as pruritus, jaundice, abdominal discomfort or pain , reactive cholecystitis, anaphylactic shock after rupture. The objective of this study is to determine factors that can predict biliary complications and management options for these complications. We included in the study 364 patients operated on in our hospital between 2003-2014, with liver echinoccocosis, with a total of 533 cysts, most of them located in the right lobe (72%), with a median dimension of 9 cm. We included in the study the demographic data of the patients, GGT, Eosinophiles and ELISA IGG values, location and dimension of the cyst, surgical procedures performed , complications and the presence of biliary fistulas. We compared the group with biliary complications and observed some variation of evolution, regarding the hospital stay and also the choosing of the surgical procedure. Most often procedure performed was the cystectomy with partial pericystectomy, with drainage of the remaining cavity associated or not with cholecystectomy, this proving to have also the least number of complications. The biliary fistulas in postoperatory monitoring either closed spontaneously or with the aid of ERCP technique. Open surgery approach remains the best option for cure of the liver hydatidosis, associated with postoperatory measures of managing different complications.

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