Cystobiliary communication in hepatic hydatid cyst: predictors and outcome

Nakeeb, Ayman El; Salem, Ali; Sorogy, Mohamed El; Mahdy, Youssef; Ellatif, Mohamed Abd; Moneer, Ahmed; Said, Rami; Ghawalby, Ahmed El; Ezzat, Helmy

doi:10.5152/tjg.2017.17553

Cited by 29 publications

(41 citation statements)

References 28 publications

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“…Furthermore, Nooghabi et al reported 27.3% biliary fistula rate in 73 patients [6]. In large number of studies; Baraket et al reported 8 biliary fistulas in 120 patients (10.4%), Surmelioglu et al reported 36 fistulas in 186 patients (19.4%) and Nakeeb et al reported 13 fistulas in 123 patients (10.5%) [7,8,9]. In our study, we found postoperative biliary fistula in 14 patients (26.4%).…”

Section: Discussionmentioning

confidence: 99%

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Karabay

Bostancı

2018

Archives of Clinical and Experimental Medicine

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Aim: The biliary fistula development after liver hydatid cyst surgery is a common complication. The aim of this study is to examine the factors affecting the development of postoperative biliary fistula in patients operated for liver hydatid disease. Methods: The study was retrospectively performed in patients treated surgically for liver hydatid cyst between 1999 and 2010. The data of 53 patients operated for hydatid csyt were reviewed with hospital records. Patients were divided into two groups as biliary fistulas with (Group A) and without biliary fistula (Group B). The demographic data (age, sex), cyst diameter, cyst localization, laboratory tests and length of hospital stay were recorded. These parameters were compared with the groups. Results: The groups were similar in terms of age and sex (p = 0.790 and p=1.0, respectively). In group A, the mean cyst diameter was significantly higher than group B (p=0.001). The mean duration of hospitalization was longer in group A than group B (p=0.001). There was no difference between the groups considering cyst localization, AST, ALT, total bilirubin and direct bilirubin (p>0.05 for all). Conclusion: Preoperative cyst diameter may be a valuable parameter for predicting biliary fistula preoperatively. However, larger prospective studies are needed on this subject.

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Section: Discussionmentioning

confidence: 99%

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Karabay

Bostancı

2018

Archives of Clinical and Experimental Medicine

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“…There are few studies investigating the predictive factors for CBC. While Akcan et al reported that older age, larger cysts, and presence of multiple and bilobar cysts are associated with increased intrabiliary rupture rates, El Nakeeb et al suggested that only the cyst size (>10 cm) is a significant predictor for CBC, regardless of the type [10,14]. Because clinical presentation differs between frank and occult CBC, preoperative evaluation will be discussed separately.…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…ERCP with endoscopic sphincterotomy (ES) is the first line of treatment for patients presenting with jaundice or findings of IBR [11]. In case of documented CBC, it helps with planning the elective surgery and prevention of intraoperative common bile duct exploration during the operation [10][11][12]. Additionally, lower postoperative biliary fistula rates were reported with preoperative ERCP with ES [11].…”

Section: Echinococcosismentioning

confidence: 99%

“…In low-flow fistulas (flow rate of <300 ml/day), conservative follow-up for 3 weeks is appropriate since most of low-flow fistulas close spontaneously in this period [8,9]. If the fistula persists after 3 weeks, then ERCP with ES should be planned [8,10,11]. In high-flow fistulas (>300 ml/day), spontaneous closure of the fistula is unlikely; thus, ERCP with ES should be performed without delay [8,20].…”

Section: Postoperative Evaluationmentioning

confidence: 99%

“…It can be classified as "low-flow fistula" if the daily drainage volume is less than 300 ml/day or "high-flow fistula" if more than 300 ml/day [8,9]. If the fistula persists more than 3 weeks or is a high-flow fistula, then endoscopic or surgical intervention should be considered rather than a conservative approach [8,10,11]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Biliary Complications of Hepatic Hydatid Cyst Surgery and Prevention Methods

Konca¹,

Balcı²

2017

Echinococcosis

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Cystic echinococcosis is still one of the main reasons for liver surgery especially in endemic areas. The most common complication of liver hydatid cyst is cystobiliary communication (CBC). Preoperative or intraoperative diagnosis of CBC is essential for the treatment, since it leads to postoperative bile leakage and fistula formation eventually without intervention. Predictive factors such as cyst size, history of jaundice, and degenerated cysts are described for preoperative evaluation. Further preoperative study can be performed for diagnosis in their presence. At the intraoperative phase, every effort should be performed for diagnosis. There are several methods for the investigation of CBC. When a CBC is found, it is also essential to evaluate the biliary system as well. By this way, postoperative complication rates can be lowered. Biliary leakage and fistula formation are the most common postoperative complication of liver hydatid surgery and they are the main reasons of morbidity and mortality. Their rates can be lowered by knowing how to interfere for the treatment. As a result, every effort should be made to detect and prevent these complications during the evaluation and management of cystic echinococcosis.

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Nomogram Analysis and Internal Validation to Predict the Risk of Cystobiliary Communication in Patients Undergoing Hydatid Liver Cyst Surgery

Zhan

Pang

et al. 2020

World j. surg.

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Purpose Biliary leakage caused by cystobiliary communication (CBC) is a common clinical concern. This study sought to identify predictors of CBC in hepatic cystic echinococcosis (HCE) patients undergoing hydatid liver cyst surgery and establish nomograms to predict CBC. Methods A predictive model was established in a training cohort of 310 HCE patients diagnosed between January 2013 and May 2017. Upon revision of the records of clinical parameters and imaging features of these patients, the lasso regression model was used to optimize feature selection for the CBC risk model. Combined with feature selection, a CBC nomogram was developed with multivariable logistic regression. C-index and calibration plots were used to analyze and evaluate the discrimination and calibration. The net benefit and predictive accuracy of the nomogram were performed via decision curve analysis (DCA) and receiver operating characteristic (ROC) curve. An independent validation cohort of 132 patients recruited from June 2017 to May 2019 was used to evaluate the practicability of the nomogram. Results Predictors contained four features, namely alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), cyst size and cyst location. The C-index of the nomogram is 0.791 (95% CI, 0.736–0.845), while the C-index verified by bootstrap is 0.746, indicating high prediction accuracy. The area under the curve (AUC) of the CBC in training was 0.766. ROC curve analysis demonstrated high sensitivity and specificity. Decision curve analysis confirmed the CBC nomogram was clinically useful when the intervention was determined at the non-adherence possibility threshold of 8%. Conclusion The nomogram developed using the ALP, GGT, cyst size and cyst location could be used to facilitate the CBC risk prediction in HCE patients.

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Cystobiliary communication in hepatic hydatid cyst: predictors and outcome

Cited by 29 publications

References 28 publications

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Biliary Complications of Hepatic Hydatid Cyst Surgery and Prevention Methods

Nomogram Analysis and Internal Validation to Predict the Risk of Cystobiliary Communication in Patients Undergoing Hydatid Liver Cyst Surgery

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