Angiocholitis Due to Hydatid Cyst of the Liver Fistulized in the Bile Ducts: Comparative Study between Surgical Treatment and Endoscopic Treatment

Abstract

Background: Liver hydatid is a parasitic disease considered benign but can become dangerous because of its complications. The fistula in biliary tract remains one of the most feared complications by its frequency, morbidity and mortality. Materials and methods: We present a descriptive and comparative retrospective study at the university hospital Hassan II of Fez. This study was carried out on 63 cases of angiocholitis on hydatid cyst of the liver fistulized in the bile ducts and extends over a period of 5 years from January 2015 to December 2019. The objective of this study is to evaluate and compare the contribution of different therapeutic modalities in the treatment of cystic biliary fistula (Surgical treatment against endoscopic treatment). Results: Surgical treatment was used in 22 patients against 41 patients who underwent endoscopic treatment. The success rate of endoscopic treatment was higher than that of surgical treatment (83% against 73 %, p = 0.350). The mortality rate was reduced in the endoscopy group compared with patients in the surgery group (5% against 14 %, p = 0.226). General morbidity and major morbidity were higher significantly in patients treated surgically (General morbidity: surgery 41% against 2% for endoscopy, P0.05). Conclusion: Endoscopic treatment should be considered as the treatment of choice for angiocholitis due to hydatid cyst of the liver fistulized in the bile ducts.