Hepatic hydatid cyst communicating with the biliary tract

Liver Echinococcosis complicated with Lesions of Bile Ducts in Azerbaijan

A total of 302 patients with liver echinococcosis (LE) complicated by lesions of bile duct during 1988 to 2015 were analyzed. The patients were divided into two groups. In the first group, 227 patients were included with lesions of segmental bile ducts in the form of cystobiliary and bilio-bronchial fistulas. In the second group, 75 patients with lesions of hepatic bile were enrolled. Diagnosis of LE and its complications was made by ultrasonography and computed tomography (CT). Surgical treatment included echinococcectomy with complete liquidation of a residual cavity (35.1%), echinococcectomy with suturing (46.0%), external drainage of a residual cavity (7.3%), pericystectomy (8.6%), and resection of a liver (3.0%). Postoperative complications related to operative intervention developed in 29 patients. Lethal outcomes took place in 6 cases (2.0%). The analysis has shown that the form of bile duct lesions, methods of surgical operation for liquidation of hydatid cysts, and its biliary complications had influenced the treatment outcome. More optimal results are received after complete liquidation of residual cavity in different ways and suturing of cystobiliary fistulas during operation. For prevention of complications related to the presence of residual cavity, laser processing of walls of a residual cavity by ozonized 17% hypertonic solution of NaCl was used and this procedure showed obvious (p < 0.05) advantages.

Sonographic and computed tomographic demonstration of hydatid cysts communicating with the biliary tree

Hepatic hydatid disease is usually silent and discovered incidentally. Rupture of a hydatid cyst into the biliary tree is a serious complication and produces a clinical picture of biliary obstruction. We present the cases of 2 patients who had only nonspecific symptoms and laboratory test results indicative of biliary tract obstruction. The results of sonographic examinations of both patients strongly suggested the presence of hepatic hydatid cysts communicating with the biliary tree. CT examination provided additional information in 1 patient but only confirmed the sonographic findings in the other. Both cases were surgically confirmed. Demonstration of the cyst and intrabiliary hydatid contents should form the basis for the diagnosis of a hydatid cyst's rupture into the biliary tree; detecting the point of communication further supports the diagnosis. An accurate preoperative diagnosis of this disease is essential for its prompt surgical management.