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Trigui A, Fendri S, Akrout A, Trabelsi J, Daoud R, Saumtally MS, Ketata S, Baklouti S, Boujelbene W, Mzali R, Dziri C, Rejab H, Boujelbene S. Predictive factors of occult cystobiliary fistulas during conservative treatment of hepatic hydatid cyst: a prospective study. J Gastrointest Surg 2024; 28:108-114. [PMID: 38445931 DOI: 10.1016/j.gassur.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/04/2023] [Accepted: 10/14/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Occult cystobiliary fistula (CBF) is a common complication of hepatic hydatid cyst (HHC). It is often the cause of high morbidity of conservative treatment of HHC. This study aimed to determine the predictive factors of occult CBF to establish the indications for the investigation and treatment of these CBFs. METHODS This was a prospective study that included all operated HHCs over a 3-year period. HHCs complicated with large CBFs were not included in the study. Systematic cholecystectomy and methylene blue test for all cysts were performed. RESULTS A total of 46 patients operated on with 113 cysts were included in this study. The median cyst size was 6.7 cm (IQR, 1-38). A total of 114 CBFs were detected in 51 cysts (45.1%). The postoperative course was simple in 95.0% of cases. The specific morbidity rate was 2.7%. In a bivariate study, absence of mass and abdominal pain on palpation, hemoglobin level >11.55 g/dL, negative hydatid serology, cyst size, absence of calcifications, vascular compression, existence of a single cyst, and localization at segment VIII were predictive factors of occult CBF. At the end of the multivariate study, cyst size was determined to be the only predictive factor for occult CBF. A threshold of 3 cm was used. CONCLUSION Cyst size is a major predictive factor for occult CBF.
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Affiliation(s)
- Aymen Trigui
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia.
| | - Sami Fendri
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Amira Akrout
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Jihen Trabelsi
- Department of Epidemiology, Faculty of Medicine, Hedi Cheker Hospital, University of Sfax, Sfax, Tunisia
| | - Rahma Daoud
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Mohamed Saad Saumtally
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Salma Ketata
- Department of Anesthesiology, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Soulaymen Baklouti
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Wael Boujelbene
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Rafik Mzali
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Chadli Dziri
- Department of General Surgery, Medical School of Tunis, University of Tunis El Manar, Tunis, Tunisia; Honoris Medical Simulation Center, Tunis, Tunisia
| | - Haithem Rejab
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
| | - Salah Boujelbene
- Department of General and Digestive Surgery, Faculty of Medicine, Habib Bourguiba Hospital, University of Sfax, Sfax, Tunisia
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Sharma K, Sharma R, Kast S, Tiwari T. Hepatic hydatid cyst fistulised into the hepatic flexure: CT evaluation of a rare complication. BMJ Case Rep 2022; 15:e250874. [PMID: 35853680 PMCID: PMC9301801 DOI: 10.1136/bcr-2022-250874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kritika Sharma
- Radiodiagnosis, Pacific Institute of Medical Sciences, Umarda, Udaipur, Rajasthan, India
| | - Rajaram Sharma
- Radiodiagnosis, Pacific Institute of Medical Sciences Umarda, Udaipur, Rajasthan, India
- Radiodiagnosis, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Sunil Kast
- Radiodiagnosis, Pacific Institute of Medical Sciences, Umarda, Udaipur, Rajasthan, India
| | - Tapendra Tiwari
- Radiodiagnosis, Pacific Institute of Medical Sciences Umarda, Udaipur, Rajasthan, India
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Taş I, Aday U, Yiğit YD, Yiğit E. Analysis of Rare Spontaneous Intraperitoneal Hydatic Cyst Rupture: a Multicentric Experience. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03268-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Cruz Cidoncha A, Rúiz-Tovar J, Robín A, San Miguel C, Pérez-Flecha M, Galván A, Minaya A, Aguilera Velardo A, López-Quindós P, Moreno A, Jiménez C, González E, Medina Pedrique M, García-Ureña MA. Is Surgery for Hepatic Echinococcosis Appropriate in a Low-Volume Center? Surg Infect (Larchmt) 2021; 22:1081-1085. [PMID: 34449274 DOI: 10.1089/sur.2021.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Cystic echinococcosis is a parasitic disease that develops in endemic areas due to the transmission of Echinococcus granulosus. The liver is the organ most affected. The most frequent symptoms include pain, palpable mass, jaundice, and fever. Diagnosis is based on epidemiologic history, examination, imaging, and serologic tests. Patients and Methods: We conducted a retrospective study of patients with hepatic echinococcosis diagnosed in our center. We collected data from our patients regarding personal history, cyst characteristics, surgery performed, and post-operative complications. Results: Sixteen patients were diagnosed with hepatic echinococcosis, 11 of whom underwent surgery. We found multiple cysts in six patients (37.5%) and a single cyst in 10 (62.5%). In 14 patients the cysts were found only in the right hepatic lobe (87.5%) and in two patients they were found in both lobes (12.5%). Segment 4 was affected in seven cases. The sizes ranged from 2.7 to 20 cm. Endoscopic retrograde cholangiopancreatography was prior to surgery in five patients. The interventions performed were partial cyst-pericystectomies in eight patients, a total cyst-pericystectomy in one case, and drains were placed in two cases of rupture. Post-operative fistulas were evident in five patients, four of which were closed. The fifth, which occurred after emergency surgery for rupture of the cyst, has maintained suppuration. The mean follow-up was 3.5 years. There was no post-operative mortality or recurrence to date. Conclusions: We can state that center without highly specialized hepato-biliary surgery units can assume the surgery of hydatid liver cysts excluding those with well-defined characteristics. The establishment of recommendations for the referral of patients with complex hydatid cysts may help in the optimal management of this pathology.
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Affiliation(s)
- Arturo Cruz Cidoncha
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Jaime Rúiz-Tovar
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Alvaro Robín
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Carlos San Miguel
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Marina Pérez-Flecha
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Armando Galván
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Ana Minaya
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Asunción Aguilera Velardo
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Patricia López-Quindós
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Almudena Moreno
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Carmen Jiménez
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Enrique González
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Manuel Medina Pedrique
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - Miguel A García-Ureña
- General and Digestive Surgery Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
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Saldaña C, Bolado F, González de la Higuera B, Borobio E, Casi MA. Biliary stenosis secondary to fistulised hydatid cyst that mimics Klatskin tumour. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 43:455-456. [PMID: 32444237 DOI: 10.1016/j.gastrohep.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/14/2019] [Accepted: 01/23/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Cristina Saldaña
- Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - Federico Bolado
- Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | | | - Erika Borobio
- Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - Maria Angeles Casi
- Servicio de Aparato Digestivo, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
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TURGUT B, BARAN N. CE1 ve CE3a karaciğer kist hidatiklerinin perkütan tedavisinde modifiye Seldinger ve trokar yöntemlerinin karşılaştırılması. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.675478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Complications of hepatic echinococcosis: multimodality imaging approach. Insights Imaging 2019; 10:113. [PMID: 31792750 PMCID: PMC6889260 DOI: 10.1186/s13244-019-0805-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023] Open
Abstract
Hydatid disease is a worldwide zoonosis endemic in many countries. Liver echinococcosis accounts for 60-75% of cases and may be responsible for a wide spectrum of complications in about one third of patients. Some of these complications are potentially life-threatening and require prompt diagnosis and urgent intervention. In this article, we present our experience with common and uncommon complications of hepatic hydatid cysts which include rupture, bacterial superinfection, and mass effect-related complications. Specifically, the aim of this review is to provide key imaging features and diagnostic clues to guide the imaging diagnosis using a multimodality imaging approach, including ultrasound (US), computed tomography (CT), magnetic resonance (MR), and endoscopic retrograde cholangiopancreatography (ERCP).
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