Presse medicale (Paris, France : 1983) · 2001
[Internal trans-Oddi's sphincter fistula drainage of hydatid cysts communicating with the bile ducts].
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Beyrouti M I, Kharrat M, Elleuch S, Affes N, Gargouri F, Karoui A, Kchaou M S
Аннотация
OBJECTIVE: The purpose of this study was to examine the contribution of internal trans-fistulary drainage without opening the cystic cavity for the treatment of hydatic cyst of the liver.
PATIENTS AND METHODS: Between 1985 and 1990, 14 patients with hydatid cyst of the liver communicating with the bile duct were treated by internal trans-fistulary drainage without opening the hydatic cavity. Choledocoscopy demonstrated good bile flow without a remaining cystic fragment in all cases. The residual cavity was drained via an external drain in the common bile duct. A second hydatic cyst of the liver was also treated in 4 patients.
RESULTS: Internal trans-fistulary drainage was achieved easily. There were two treatment-related postoperative complications: bilary leakage in one patient and infection of the residual cavity leading to septicemia and death in another.
CONCLUSION: Internal trans-fistulary drainage without opening the hydatic cavity is indicated for central hydatic cyst of the liver measuring less than 15 cm with a flexible pericyst and a large biliocystic fistula measuring more than 5 mm. Peroperative choledochoscopy of the hydatic cavity is necessary.
PATIENTS AND METHODS: Between 1985 and 1990, 14 patients with hydatid cyst of the liver communicating with the bile duct were treated by internal trans-fistulary drainage without opening the hydatic cavity. Choledocoscopy demonstrated good bile flow without a remaining cystic fragment in all cases. The residual cavity was drained via an external drain in the common bile duct. A second hydatic cyst of the liver was also treated in 4 patients.
RESULTS: Internal trans-fistulary drainage was achieved easily. There were two treatment-related postoperative complications: bilary leakage in one patient and infection of the residual cavity leading to septicemia and death in another.
CONCLUSION: Internal trans-fistulary drainage without opening the hydatic cavity is indicated for central hydatic cyst of the liver measuring less than 15 cm with a flexible pericyst and a large biliocystic fistula measuring more than 5 mm. Peroperative choledochoscopy of the hydatic cavity is necessary.