OP 68. Surgical Management of Great Saphenous Varicosities: A Meta-Analysis

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N. Lynch, M. Clarke, G. Fulton

Chair(s): Roland Demaria, Mustafa Cikirikcioglu& Violetta Kékesi

8:20 - 8:30h at Buda Room (B)

Categories: Cardiac and Vascular Surgery, Oral Session

Session: Oral Session VIII - Cardiac and Vascular Surgery II

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Background
Hydatid disease is still one of the important health problems on the worldwide. Biliary fistula is  the most frequent complication of hepatic hydatid cysts. The purpose of this study is to perform a  review on demographic features, clinical findings, diagnostic and therapeutic options to treat
communication between hydatid cyst and biliary ducts.

Material and Methods
The hospital records of patients underwent surgical treatment for hepatic hydatid cysts were  reviewed between 2008 and 2013. The results of patients with cystobiliary fistula were  evaluated.

Result
There were cisto-biliary fistula in 26 (15.5%) of 166 patients. Twenty cases were females and 6  cases were females. Cystobiliary connection was detected intraoperatively in 20 (%73) cases and  postoperatively in 7 (27%) cases. Suturing visible biliary orifices in the cyst was performed in 13  (50%) patients and T tube drainage was placed in 6 (23.1%) patients. In 4 (15.3%) cases, any  intervention didn’t make for cystobiliary connection because there were no visible biliary  orifices. Endoscopic retrograde colangiopancreaticography (ERCP) were performed in the 5  (19.2%) cases. There was major morbidity (biliary collection) in 2 (7.6%) patients who was  undetected cystobiliary connection intraoperatively. They were treated percutaneously. There  was no mortality.

Conclusion
The management of cystobiliary fistulas is important. Cystobiliary fistulas increases morbidity  and hospitalisation period. Suturing cystobiliary fistula and/or T tube drainage is an effective method for intraoperatively detected fistulas. The detection and suturing cystobiliary  communications during surgery reduces postoperative biliary complications. Endoscopic retrograt colangiopancreaticography is an method to manage cystobiliary fistulas in the postoperative period