PP 68. The Management of Cystobiliary Fistulas Is Important Issues in the Treatment of Hepatic
A Uzunköy
18:58 - 19:04h
at Lanchid Room
Categories: Hepatobiliary and Pancreatic Surgery, Poster Session
Session: Poster (P5) - Hepatobiliary & Pancreatic Surgery
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.
