Objective:

Ten patients who underwent hydatid cyst surgery were evaluated retrospectively show the relationship between surgical technique and postoperative bile leakeage.

Material and Methods:

Ten cases with different number of cysts in different diamaeters operated for hepatic hydatid disease were evaluated retrospectively. Mean age of the patients was 52.4 (14-75) with a male to female ratio of 3/7. Diagnosis was confirmed with serological tests, ultrasonography and computerized tomography.

Results:

A total number of 18 cysts were observed in 10 patients included in this study. Surgical operations applied were partial cystectomy for 11 cysts, cystotomy drainage for 3 cysts, intro-flexion for 2 cysts, and pericystectomy for 2 cysts. Of these 18 cysts, 13 cysts had clear fluid without intrabiliary rupture, and were treated by partial cystectomy or intro-flexion. After these procedures two patients had complications. External biliary fistula developed in one of them and bile peritonitis with subhepatic bilioma developed in the other. Bile fistula healed spontaneously on the tenth day. Bile peritonitis was managed by inserting a periton dialysis catheter into Douglas left for 48 hours. Subhepatic bilioma was drained percutaneously under computerized tomography and bile drainage persisted for two months, which ceased spontaneously.

Conclusion:

It is concluded that biliary leakage after partial cystectomy or cystotomy can be avoided by suturing or clipping cut edges of pericysts.

Keywords: liver hydatic cyst, bile fistula, bile peritonitis