Role of endoscopic intervention in biliary complications of hepatic hydatid cyst disease

Goumas, Konstantinos; Poulou, Androniki; Dandakis, D.; Tyrmpas, Ioannis; Georgouli, Androniki; Sgourakis, George; Soutos, D.; Karaliotas, Konstantinos

doi:10.1080/00365520701234318

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…Before the common use of MRCP, ERCP has been shown to be the most efficient method rather than USG and CT in showing rupture into bile ducts. [15] MRCP is especially a very effective imaging modality in showing the width of bile ducts and hydatid materials inside. [16] In patients presenting with jaundice and abdominal pain in our clinic, first of all, USG is performed, and then CT and MRI evaluation is performed upon detection of cystic lesion in the patient's liver (in case of suspected hydatid cyst), and ERCP procedure is performed in the common bile duct obstruction.…”

Section: Discussionmentioning

confidence: 99%

Acute Necrotizing Pancreatitis Treatment: Endoscopic Sfincterotomy and Minimal Invasive Step Up Approach of Liver Hydatid Cysts.

Akay¹

2020

Laparosc Endosc Surg Sci

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Introduction: Hydatid disease is a zoonosis that generally arises from echinococcus granulosus. Abdominal pain, cholangitis and jaundice may develop as a result of spontaneous rupture of the liver cyst into the biliary tract. Rarely, in some of these cases, pancreatitis may develop as a complication of hydatid cysts and there is no clear consensus on treatment options in patients with diffuse bile duct obstruction that occurs with a necrotizing pancreatitis clinic. The present study aims to establish a common consensus in patients presenting with liver cyst hydatid pancreatitis and jaundice clinic. Materials and Methods: In a retrospective, clinical-based multicenter study, ERCP and minimally invasive approaches are presented in the treatment of four patients who developed liver bile duct obstruction and necrotizing pancreatitis from the liver hydatid cyst. Results: All patients had abdominal pain and jaundice. Acute pancreatitis was detected in all cases using computed tomography. All patients underwent endoscopic sphincterotomy. Infected cystic material and germinal membranes were removed from the biliary tract. With endoscopic sphincterotomy, necrotizing pancreatitis clinic improved rapidly in three patients, while one patient progressed to necrotizing pancreatitis. All patients underwent laparoscopic cystectomy and cholecystectomy in combination. In patients who were followed up for necrotizing pancreatitis, the wall formation (encapsulation) period of necrosis was waited, and four weeks later, percutaneous drainage was applied to the walled necrosis areas. While the patients were discharged, Andazol® treatment was applied during the 6-month follow-up period. Conclusion: One of the complications of ERCP is that it may increase the severity of pancreatitis. However, ERCP is the most important endoscopic intervention for the treatment of pancreatitis filled with common bile duct hydatid cyst to ensure safe and effective biliary tract drainage in the early period. In addition, percutaneous drainage provides safe and rapid recovery in necrotizing pancreatitis complications when the wall of necrosis phenomenon is expected.

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Section: Discussionmentioning

confidence: 99%

Acute Necrotizing Pancreatitis Treatment: Endoscopic Sfincterotomy and Minimal Invasive Step Up Approach of Liver Hydatid Cysts.

Akay¹

2020

Laparosc Endosc Surg Sci

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“…In our study, 11.1% of the patients of our series suffered from cystobiliary fistula. Most biliary fistulas gain patency after complete decompression of the cavity and complete collapse of the endocyst (1)(2)(3)(4)(5)(6)10).…”

Section: Discussionmentioning

confidence: 99%

“…Cystobiliary fistulas have been of a great importance in both the natural processes and classical treatment stages in liver hydatid disease (1,2). The incidence of biliary tract involvement in patients with hepatic hydatidosis varies in different studies, from 1% to 17% (3,4).…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Management of Cystobiliary Fistulas by Small Catheters

Arıbaş¹,

Arda²,

Aribas

et al. 2016

Iran J Radiol

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Objectives: This study aims to use mean volume of fluid, which is drained from a liver hydatid cyst with cystobiliary fistula developing after percutaneous treatment, for determining the type of treatment as surgery versus conservative. Patients and Methods:The cohort data was collected retrospectively from 10 out of 90 hydatid cysts in 10 out of 65 patients treated percutaneously with needle and catheterization methods. Groups were defined as surgical and conservative. The mean volumes until the 20 th day after detection of the biliary fistula were used. In addition, the mean volumes until the 20 th day of 42 catheterization patients without biliary fistula were used as controls for quantitative analysis.Results: All 10 cysts with cystobiliary fistulas were managed with small (8 F) catheters. All patients in the conservative group had < 211 mL/day mean drainage for the 20 days. For the patients that developed cystobiliary fistulas of liver hydatid disease, 30% required surgical treatment. After receiver operating characteristic (ROC) curve analysis, the cut-off value for success of hydatid cyst treatment was 206 mL/day of drained content. Conclusion:To reduce superfluous costs and time, cystobiliary fistula with < 206 mL/day mean drainage until the 20 th day may be efficiently treated with percutaneous drainage using small catheters.

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“…The role of preoperative endoscopic retrograde cholangiopancreatography (ERCP) continues to be debated, with proposed benefits including preoperative definition of cystobiliary relationships, treatment of cholangitis and biliary obstruction, and possible definitive treatment in cases of intrabiliary rupture. In one study, ERCP was reported to be safe method to treat biliary complications of hepatic hydatidosis before and after surgical management [6]. ERCP, however, may cause complications and has a false negative rate of 17%–20% in identifying small cystobiliary communications due to elevated cyst pressure, minimal communication, or transient obstruction of the communication by daughter cysts [7].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Drainage of a Hepatic Echinococcal Cyst: A Case Report

Goldin

Mateka

Schnaus

et al. 2011

Case Reports in Gastrointestinal Medicine

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The Echinococcus granulosus tapeworm causes hepatic echinococcosis. It is endemic in the Mediterranean region, Middle East, and South America. Human infection is secondary to accidental consumption of ova in feces. Absorption through the bowel wall and entrance into the portal circulation leads to liver infection. This case involves a 34 y/o Moroccan male with an echinococcal liver cyst. His chief complaint was RUQ pain. The patient was treated with albendazole and praziquantel. His PMH and PSH was noncontributory. Patient was not on any other medications. ROS was otherwise unremarkable. The patient was AF VSS. He was tender to palpation in RUQ. Liver function tests were normal. Echinococcal titers were positive. CT demonstrated a large cystic lesion in the right lobe of the liver measuring 13.5 cm in diameter. The patient underwent successful laparoscopic drainage and excision of echinococcal cyst. Final pathology demonstrated degenerating parasites (E. granulosus) of echinococcal cyst.

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Role of endoscopic intervention in biliary complications of hepatic hydatid cyst disease

Abstract: This study suggests that endoscopic treatment modalities are helpful and safe methods in the treatment of biliary complications of hepatic hydatidosis before and after definitive surgical management of the hydatid cysts.

Cited by 13 publications

References 19 publications

Acute Necrotizing Pancreatitis Treatment: Endoscopic Sfincterotomy and Minimal Invasive Step Up Approach of Liver Hydatid Cysts.

Acute Necrotizing Pancreatitis Treatment: Endoscopic Sfincterotomy and Minimal Invasive Step Up Approach of Liver Hydatid Cysts.

Percutaneous Management of Cystobiliary Fistulas by Small Catheters

Laparoscopic Drainage of a Hepatic Echinococcal Cyst: A Case Report

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