[Hepatic hydatid cyst with destruction of the biliary confluent. Apropos of 2 cases treated by direct reconstruction].

The authors present two cases of hepatic echinococcus cyst with destruction of the biliary confluent. The severity of this exceptional lesion requires uncommon treatment. Experience with treatment of biliary fistulas when there is a residual cystic cavity, provides arguments for and against primary suture of these fistulas. In these cases, the required treatment consists in reconstruction of the hepatic biliary ducts destroyed (right, left and common) by using the pericystic envelope itself as a plastic neoformative element. The result has demonstrated its efficacy after many years of use, as we have indicated in this article. "Echinococcus granulosus" itself is only rarely a problem in the host, but a hepatic echinococcus cyst does not only pose a spatial problem, except insofar as it often involves the biliary tree. In the cases reported here, the hepatic echinococcus cyst causes biliary problems in over 60% of the cases (1). These biliary problems were as follows: Compression of the common bile duct by the cys; More often, compression of the intrahepatic bile ducts causes the cyst to open inside the biliary duct and to fissure, leading to a biliocystic fistula.