Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease

Abstract

Most cases of hepatic hydatid disease exhibit uncomplicated clinical course and management. However, the diagnosis and management of complicated hepatic hydatid disease is a special issue. One of the most common and serious complications of hepatic hydatid disease is the rupture of the cyst into intrahepatic bile ducts. The clinical appearance of intrabiliary rupture can range from asymptomatic to jaundice, cholecystitis, cholangitis, liver abscess, pancreatitis and septicemia. Current treatments for major ruptures can result in high morbidity and mortality rates. Furthermore, ruptures that cannot be diagnosed preoperatively can induce complications such as biliary fistulae, biloma, cavitary infection and obstructive jaundice. In the past, these complications were diagnosed and treated by surgical methods. Currently, complications in both the pre- and postoperative periods are diagnosed and treated by non-invasive or minimally invasive methods. In clinical practice, endoscopic retrograde cholangiopancreatography (ERCP) is indicated for patients with preoperative frank intrabiliary rupture in which hydatid elements are clearly seen in the bile ducts, or for biliary adverse events after surgery, including persistent biliary fistulae and jaundice. However, controversy concerning routine preoperative ERCP and prophylactic endoscopic sphincterotomy in patients suspected of having minor cystobiliary communications still remains. In this article, the role of ERCP in the diagnosis and management of hepatic hydatid disease during the pre- and postoperative periods is reviewed.

Role of Different Treatment Modalities in Cavity Volume during the Treatment of Cystic Ecchinococcosis

“…However, an increasing number of reports have been published regarding endoscopic treatment for hydatid cysts with biliary rupture, and nowadays, ERCP has emerged as a safe treatment method (3,(14)(15)(16)(17)(18)(19)(20). In our report, 14 cases were treated with only ERCP+ES.…”

Akut pankreatit ile başvuran karaciğer hidatik kistinin endoskopik kist evakuasyonu ile tedavisi

“…Akut kolanjit nedeniyle sepsis gelişmiş olan hastalarda, NBD yerleştirilmesi geçici tedavinin ilk tercihi olabilir. Ayrıca, kalan hidatik materyali safra yollarından tamamen temizlemek için ERCP tekrar yapılabilir (6). Bizim olgumuz, tek başına endoskopik kist evakuasyonu ile tedavi edildi ve ek bir tedavi yöntemine gerek duyulmadı.…”

Uncomplicated Hydatid Cysts of the Liver: Clinical Presentation, Diagnosis and Treatment

“…Magnetic resonance imaging (MRI) ensures well structural details of the hydatid cysts. Although it might be helpful for demonstrating the lesion in the liver, it does not provide additional information in hepatic lesions and it is not costeffective when compared with either ultrasonography or CT [21,22]. MRI is especially indicated in cerebral pathologies.…”