Endoscopic sphincterotomy in the management of postoperative complications of hepatic hydatid disease.

The results obtained using endoscopic sphincterotomy (EST) in the management of postoperative biliary complications of hepatic hydatid disease are presented. The outcome was favourable in all eight patients treated with no associated morbidity or mortality. In three patients the clinical manifestations of cholangitis resolved, and in five of six patients the external bile fistula previously present for 26 to 68 days closed within 3 to 15 days. In one patient with a long-standing fistula (5 years) the bile outflow was reduced from 600cc to 50-100cc per day. No complications due to EST were encountered. The results show that EST can be considered the treatment of choice for biliary fistulae following surgery for hepatic hydatid disease and for drainage of bile in patients with cholangitis due to hydatid disease.