Araştırma Makalesi
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Yıl 2022, Cilt: 5 Sayı: 4, 942 - 948, 20.07.2022
https://doi.org/10.32322/jhsm.1112941

Öz

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Kaynakça

  • Salamone G, Licari L, Randisi B, et al. Uncommon localizations of hydatid cyst. Review of the literature. G Chir 2016; 37: 180-5.
  • Çiçek B, Parlak E, Dişibeyaz S, Oğuz D, Cengiz C, Şahin B. Endoscopic therapy of hepatic hydatid cyst disease in preoperative and postoperative settings. Dig Dis Sci 2007; 52: 931–5.
  • Altıntaş N. Cystic and alveolar echinococcosis in Turkey. Ann Trop Med Parasitol 1998; 92: 637-42.
  • Kammerer WS, Schantz PM. Echinococcal disease. Infect Dis Clin North Am 1993; 7: 605-18.
  • Bayrak M, Altıntaş Y. Current approaches in the surgical treatment of liver hydatid disease: single center experience. BMC Surg 2019; 17; 19: 95.
  • Akcan A, Sözüer E, Akyıldız H, Özturk A, Atalay A, Yılmaz Z. Predisposing factors and surgical outcome of complicated liver hydatid cysts. World J Gastroenterol 2010; 28: 3040–8.
  • Wang Z, Xu J, Pang MQ, et al. nomogram analysis and internal validation to predict the risk of cystobiliary communication in patients undergoing hydatid liver cyst surgery. World J Surg 2020; 44: 3884-92.
  • Mihmanli M, Idiz MU, Kaya C, et al. Current status of diagnosis and treatment of hepatic echinococcosis. Rev World J Hepatol 2016; 8: 1169-81.
  • Botezatu C, Mastalier B, Patrascu T. Hepatic hydatid cyst - diagnose and treatment algorithm. J Med Life 2018; 11: 203-9.
  • Sözüer E, Akyüz M, Akbulut S. Open surgery for hepatic hydatid disease. Int Surg 2014; 99: 764-9.
  • Ramia JM, Figueras J, De la Plaza R, García-Parreño J. Cysto-biliary communication in liver hydatidosis. Langenbecks Arch Surg 2012; 397: 881–7.
  • Uylas U, Tardu A and Kayaalp C. Bile leakage test in emergency hydatid liver cyst surgery. Int J Surg Case Rep 2021; 79: 459–61.
  • Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: advances in the 21st century. Clin Microbiol Rev 2019; 13; 32
  • Romig T, Zeyhle E, Macpherson CN, Rees PH, Were JB. Cyst growth and spontaneous cure in hydatid disease. Lancet 1986: 861.
  • Wang Y, He T, Wen X, et al. Post-survey follow-up for human cystic echinococcosis in northwest China. Acta Trop 2006: 43-51.
  • Brunetti E, Kern, P, Vuitton DA. Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114: 1-16.
  • Fancellu A, Perra T, Vergari D, et al. Management of complex liver cystic hydatidosis: challenging benign diseases for the hepatic surgeon: A case series report from an endemic area. Comparative Study Med 2020; 25; 99.
  • Lewall DB, McCorkell SJ. Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Röntgenol 1986; 146: 391–4.
  • Prousalidis J, Kosmidis C, Kapoutzis K, Fachantidis E, Harlaftis N, Aletras H. Intrabiliary rupture of hydatid cysts of the liver. Am J Surg 2009; 197: 193–8.
  • Zargar SA, Khuroo MS, Khan BA, et al. Intrabiliary rupture of hepatic hydatid cyst: sonographic and cholangiographic appearances. Gastrointest Radiol 1992: 1741- 5.
  • Atli M, Kama NA, Yuksek YN. Intrabiliary rupture of a hepatic hydatid cyst associated clinical factors and proper management. Arch Surg 2001; 136: 1249-55.
  • El Malki HO, Mejdoubi Y, Souadka A, Mohsine R, Ifrine L, Abouqal R. Predictive factors of deep abdominal complications after hydatid cysts of the liver: 15 years of experience with 672 patients reply. J Am Coll Surg 2010; 206: 629–37.
  • Kornaros SE, Aboul-Nour TA. Frank intrabiliary rupture of hydatid hepatic cyst: diagnosis and treatment. J Am Coll Surg 1996; 183: 446-70.
  • Demircan O, Baymus M, Seydaoglu G, et al. Occult cystobiliary communication presenting as postoperative biliary leakage after hydatid liver surgery: are there significant preoperative clinical predictors. Can J Surg 2006; 49: 177–84.
  • Kayaalp C , Bostancı B, Yol S, Akoglu M. Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications. Am J Surg 2003; 185: 175-9.
  • Mihăilă DE, Potecă TD, Potecă A, Piţuru S. Single-centre epidemiological study on the incidence of hepatic hydatid cyst. Rom J Intern Med 2015; 53: 170-3.
  • Bhutani N, Kajal P. Hepatic echinococcosis: A review. Ann Med Surg (Lond) 2018; 36: 99-105.
  • Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol 2012; 18: 1448-58.
  • Harris JD. Rupture of Hydatid Cysts of the Liver into the Biliary Tracts. Br J Surg 1965; 52: 210–14.
  • Atahan K, Küpeli H, Deniz M, Gür S, Cökmez A, Tarcan E. Can occult cystobiliary fistulas in hepatic hydatid disease be predicted before surgery? Int J Med Sci 2011; 8: 315-20.
  • Aghayev RM. Liver Echinococcosis complicated with Lesions of Bile Ducts in Azerbaijan. Euroasian J Hepatogastroenterol 2016; 6: 125-30.
  • Unalp HR, Baydar B, Kamer E, Yilmaz Y, Issever H, Tarcan E. Asymptomatic occult cysto-biliary communication without bile into cavity of the liver hydatid cyst: a pitfall in conservative surgery. Int J Surg 2009;7: 387-91.
  • Kenan E, Dervişoğlu A, Polat C, Senyurek G, Yetim İ, Hokelek M. Intrabiliary rupture: an algorithm in the treatment of controversial complication of hepatic hydatidosis. World J Gastroenterol 2005; 11: 2472-6.
  • Dziri C, Paquet JC, Hay JM, et al. Omentoplasty in the prevention of deep abdominal complications after surgery for hydatid disease of the liver: a multicenter, prospective, randomized trial. J Am Coll Surg 1999; 188: 281-9.
  • Bedirli A, Sakrak O, Sozuer EM, Kerek M, Ince O. Surgical management of spontaneous intrabiliary rupture of hydatid liver cysts. Surg Today. 2002; 32: 594-7.
  • Aydın U, Yazıcı P, Onen Z, et al. The optimal treatment of hydatid cyst of the liver: radical surgery with a significant reduced risk of recurrence. Turk J Gastroenterol 2008: 33-9.
  • Zaouche A, Haouet K, Jouini M, El Hachaichi A, Dziri C. Management of liver hydatid cysts with a large biliocystic fistula: multicenter retrospective study. Tunisian Surgical Association. World J Surg 2001; 25: 28-39.
  • Kayaalp C, Aydın C, Ölmez A, Işık S, Yılmaz S. Leakage tests reduce the frequency of biliary fistulas following hydatid liver cyst surgery. Clinics 2011; 66: 421–4.
  • Ghannouchi M, Rodayna H, Khalifa BM, Nacef K, Boudokhan M. Postoperative morbidity risk factors after conservative surgery of hydatic cyst of the liver: a retrospective study of 151 hydatic cysts of the liver. BMC Surg 2022; 22: 120.
  • Akbulut S, Şenol A, Sezgin A, Cakabay B, Dursun M, Satıcı O. Radical vs conservative surgery for hydatid liver cysts: experience from single center. World J Gastroenterol 2010; 16: 953-9.
  • Vuitton DA, Azizi A, Richou C, et al. Current interventional strategy for the treatment of hepatic alveolar echinococcosis. Expert Rev Anti Infect Ther 2016; 14: 1179–94

Surgical treatment of liver hydatic cyst and evaluation of cystobiliary fistula: experience of two centers

Yıl 2022, Cilt: 5 Sayı: 4, 942 - 948, 20.07.2022
https://doi.org/10.32322/jhsm.1112941

Öz

Objective: Intrabiliary rupture or cystobiliary fistula is the most common complication of hepatic hydatid cyst. In this article, our objective is to evaluate the clinical, laboratory, imaging, surgical treatment and results of cystobiliary fistulas, which is the most common complication of hydatid cysts.
Material and Method: In our study, patients who underwent open surgery and were followed up and treated for hydatid cyst in the gastroenterology and general surgery outpatient clinic and service between years 2015-2021 were included. The clinical, laboratory, radiological and surgical results of 171 patients with hydatid cysts were retrospectively analyzed.
Results: The mean age of 171 patients who underwent surgery for hydatid cyst was 44.8 (18-71), 68 of whom were men and 103 were women. Bile leakage was present in 50 patients (50 (29.23%)). There were 24 (48%) men and 26 (52%) women with bile leakage. The cyst diameter was 74.2 (36-170) mm and the number of cysts was 1.2 (1-2). The cysts were located in the right lobe of the liver in 116 (79%) patients, in the left lobe in 30 (15%) patients, and in both lobes in 25 (6%) patients. Cystobiliary fistula developed more frequently, especially in cysts located in the right lobe(36 (72%)). Cystobiliary fistula was most common in CE3 (Gharbi type 2) type (30 (60%)). Cystectomy+drainage was performed in 137 (80%) patients in all groups. Cystectomy and drainage were the most common surgical procedures. The cyst diameter was 10 cm in the group with cystobiliary fistula and was significant compared to the group without fistula (p<0.001). Aminotransferase (AST and ALT) levels were high in patients with cystobiliary fistula (p=0.012, p=0.054). However, there was no significant difference between the two groups in alkaline phosphatase, total bilirubin, and gamma glutamyl transferase (p=0.231, p=0.097, p=0.544).
Conclusion: Liver hydatid cyst is endemic in our country as well as in many other countries in the world. Complicated hepatic hydatid cysts require timely and appropriate treatment because of their life-threatening complications. Cytobiliary fistula is the most common complication. In the surgical treatment of hydatid cyst disease, the earlier the diagnosis of occult cystobiliary fistulas is made (especially in the preoperative or peroperative period), the easier the treatment is, and the risk of bile leakage and consequently the morbidity and mortality decreases. Our results and experience showed that treatment and complications are related to the location and size of the cyst, occult/large cystobiliary fistula, detectability of occult fistulas, experienced center and surgeon.

Kaynakça

  • Salamone G, Licari L, Randisi B, et al. Uncommon localizations of hydatid cyst. Review of the literature. G Chir 2016; 37: 180-5.
  • Çiçek B, Parlak E, Dişibeyaz S, Oğuz D, Cengiz C, Şahin B. Endoscopic therapy of hepatic hydatid cyst disease in preoperative and postoperative settings. Dig Dis Sci 2007; 52: 931–5.
  • Altıntaş N. Cystic and alveolar echinococcosis in Turkey. Ann Trop Med Parasitol 1998; 92: 637-42.
  • Kammerer WS, Schantz PM. Echinococcal disease. Infect Dis Clin North Am 1993; 7: 605-18.
  • Bayrak M, Altıntaş Y. Current approaches in the surgical treatment of liver hydatid disease: single center experience. BMC Surg 2019; 17; 19: 95.
  • Akcan A, Sözüer E, Akyıldız H, Özturk A, Atalay A, Yılmaz Z. Predisposing factors and surgical outcome of complicated liver hydatid cysts. World J Gastroenterol 2010; 28: 3040–8.
  • Wang Z, Xu J, Pang MQ, et al. nomogram analysis and internal validation to predict the risk of cystobiliary communication in patients undergoing hydatid liver cyst surgery. World J Surg 2020; 44: 3884-92.
  • Mihmanli M, Idiz MU, Kaya C, et al. Current status of diagnosis and treatment of hepatic echinococcosis. Rev World J Hepatol 2016; 8: 1169-81.
  • Botezatu C, Mastalier B, Patrascu T. Hepatic hydatid cyst - diagnose and treatment algorithm. J Med Life 2018; 11: 203-9.
  • Sözüer E, Akyüz M, Akbulut S. Open surgery for hepatic hydatid disease. Int Surg 2014; 99: 764-9.
  • Ramia JM, Figueras J, De la Plaza R, García-Parreño J. Cysto-biliary communication in liver hydatidosis. Langenbecks Arch Surg 2012; 397: 881–7.
  • Uylas U, Tardu A and Kayaalp C. Bile leakage test in emergency hydatid liver cyst surgery. Int J Surg Case Rep 2021; 79: 459–61.
  • Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: advances in the 21st century. Clin Microbiol Rev 2019; 13; 32
  • Romig T, Zeyhle E, Macpherson CN, Rees PH, Were JB. Cyst growth and spontaneous cure in hydatid disease. Lancet 1986: 861.
  • Wang Y, He T, Wen X, et al. Post-survey follow-up for human cystic echinococcosis in northwest China. Acta Trop 2006: 43-51.
  • Brunetti E, Kern, P, Vuitton DA. Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010; 114: 1-16.
  • Fancellu A, Perra T, Vergari D, et al. Management of complex liver cystic hydatidosis: challenging benign diseases for the hepatic surgeon: A case series report from an endemic area. Comparative Study Med 2020; 25; 99.
  • Lewall DB, McCorkell SJ. Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Röntgenol 1986; 146: 391–4.
  • Prousalidis J, Kosmidis C, Kapoutzis K, Fachantidis E, Harlaftis N, Aletras H. Intrabiliary rupture of hydatid cysts of the liver. Am J Surg 2009; 197: 193–8.
  • Zargar SA, Khuroo MS, Khan BA, et al. Intrabiliary rupture of hepatic hydatid cyst: sonographic and cholangiographic appearances. Gastrointest Radiol 1992: 1741- 5.
  • Atli M, Kama NA, Yuksek YN. Intrabiliary rupture of a hepatic hydatid cyst associated clinical factors and proper management. Arch Surg 2001; 136: 1249-55.
  • El Malki HO, Mejdoubi Y, Souadka A, Mohsine R, Ifrine L, Abouqal R. Predictive factors of deep abdominal complications after hydatid cysts of the liver: 15 years of experience with 672 patients reply. J Am Coll Surg 2010; 206: 629–37.
  • Kornaros SE, Aboul-Nour TA. Frank intrabiliary rupture of hydatid hepatic cyst: diagnosis and treatment. J Am Coll Surg 1996; 183: 446-70.
  • Demircan O, Baymus M, Seydaoglu G, et al. Occult cystobiliary communication presenting as postoperative biliary leakage after hydatid liver surgery: are there significant preoperative clinical predictors. Can J Surg 2006; 49: 177–84.
  • Kayaalp C , Bostancı B, Yol S, Akoglu M. Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications. Am J Surg 2003; 185: 175-9.
  • Mihăilă DE, Potecă TD, Potecă A, Piţuru S. Single-centre epidemiological study on the incidence of hepatic hydatid cyst. Rom J Intern Med 2015; 53: 170-3.
  • Bhutani N, Kajal P. Hepatic echinococcosis: A review. Ann Med Surg (Lond) 2018; 36: 99-105.
  • Nunnari G, Pinzone MR, Gruttadauria S, et al. Hepatic echinococcosis: clinical and therapeutic aspects. World J Gastroenterol 2012; 18: 1448-58.
  • Harris JD. Rupture of Hydatid Cysts of the Liver into the Biliary Tracts. Br J Surg 1965; 52: 210–14.
  • Atahan K, Küpeli H, Deniz M, Gür S, Cökmez A, Tarcan E. Can occult cystobiliary fistulas in hepatic hydatid disease be predicted before surgery? Int J Med Sci 2011; 8: 315-20.
  • Aghayev RM. Liver Echinococcosis complicated with Lesions of Bile Ducts in Azerbaijan. Euroasian J Hepatogastroenterol 2016; 6: 125-30.
  • Unalp HR, Baydar B, Kamer E, Yilmaz Y, Issever H, Tarcan E. Asymptomatic occult cysto-biliary communication without bile into cavity of the liver hydatid cyst: a pitfall in conservative surgery. Int J Surg 2009;7: 387-91.
  • Kenan E, Dervişoğlu A, Polat C, Senyurek G, Yetim İ, Hokelek M. Intrabiliary rupture: an algorithm in the treatment of controversial complication of hepatic hydatidosis. World J Gastroenterol 2005; 11: 2472-6.
  • Dziri C, Paquet JC, Hay JM, et al. Omentoplasty in the prevention of deep abdominal complications after surgery for hydatid disease of the liver: a multicenter, prospective, randomized trial. J Am Coll Surg 1999; 188: 281-9.
  • Bedirli A, Sakrak O, Sozuer EM, Kerek M, Ince O. Surgical management of spontaneous intrabiliary rupture of hydatid liver cysts. Surg Today. 2002; 32: 594-7.
  • Aydın U, Yazıcı P, Onen Z, et al. The optimal treatment of hydatid cyst of the liver: radical surgery with a significant reduced risk of recurrence. Turk J Gastroenterol 2008: 33-9.
  • Zaouche A, Haouet K, Jouini M, El Hachaichi A, Dziri C. Management of liver hydatid cysts with a large biliocystic fistula: multicenter retrospective study. Tunisian Surgical Association. World J Surg 2001; 25: 28-39.
  • Kayaalp C, Aydın C, Ölmez A, Işık S, Yılmaz S. Leakage tests reduce the frequency of biliary fistulas following hydatid liver cyst surgery. Clinics 2011; 66: 421–4.
  • Ghannouchi M, Rodayna H, Khalifa BM, Nacef K, Boudokhan M. Postoperative morbidity risk factors after conservative surgery of hydatic cyst of the liver: a retrospective study of 151 hydatic cysts of the liver. BMC Surg 2022; 22: 120.
  • Akbulut S, Şenol A, Sezgin A, Cakabay B, Dursun M, Satıcı O. Radical vs conservative surgery for hydatid liver cysts: experience from single center. World J Gastroenterol 2010; 16: 953-9.
  • Vuitton DA, Azizi A, Richou C, et al. Current interventional strategy for the treatment of hepatic alveolar echinococcosis. Expert Rev Anti Infect Ther 2016; 14: 1179–94
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orijinal Makale
Yazarlar

Hayrettin Dizen 0000-0002-4031-2557

Berrin Yalınbaş Kaya 0000-0002-1414-4115

Yayımlanma Tarihi 20 Temmuz 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 5 Sayı: 4

Kaynak Göster

AMA Dizen H, Yalınbaş Kaya B. Surgical treatment of liver hydatic cyst and evaluation of cystobiliary fistula: experience of two centers. J Health Sci Med /JHSM /jhsm. Temmuz 2022;5(4):942-948. doi:10.32322/jhsm.1112941

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