Diagnosis and treatment of intrabiliary rupture of hydatid cyst of the liver.

Thirty-nine patients with jaundice from intrabiliary rupture of hydatid cysts were treated. Nine patients underwent hepatic lobectomy; 23, total cystectomy; and seven, partial cystectomy with internal drainage by a Roux-en-Y pericystojejunostomy. Cholecystectomy was performed on 28 patients for cholelithiasis or cholecystitis. All 39 patients had choledochotomy, which was supplemented in four patients by choledochoduodenostomy because of underlying ampullar carcinoma in two patients and a high risk of potential recurrent choledocholithiasis in the other two. No biliary fistulas or recurrence of disease was elicited during the one- to 14-year follow-up period. Overall mortality was 2.56%; morbidity, 5.8%; mean (+/- SD) hospital stay, 10 +/- 2 days.