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Can Occult Cystobiliary Fistulas in Hepatic Hydatid Disease Be Predicted Before Surgery?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Atahan, Kemal Küpeli, Hakan Deniz, Mehmet Eflatun Gür, Serhat Çökmez, Atilla Tarcan, Ercüment |
| Copyright Year | 2011 |
| Abstract | BACKGROUND Biliary fistulas because of the cystobiliary communication is the most frequent and undesirable postoperative complication of hepatic hydatid surgery. We aimed to identify the predicting factors of the occult cystobiliary communication in this study. METHODS The patients who underwent surgical treatment for hepatic hydatid disease between 2003 and 2008 were reviewed retrospectively. The patients who had jaundice history, preoperative high total bilirubin and direct bilirubin levels, dilated bile duct in preoperative radiologic imagings were not included the study. Patients were divided into two groups: group A; without postoperative biliary fistula, group B; with biliary fistula. The two groups were compared according to preoperative descriptive findings, cystic specialties, and laboratory findings. RESULTS There were 53 patients and 15 patients in groupA and groupB, respectively. The 20 (37.7%) of 53 patients were male in group A and the 10 (66.7%) patients were male in group B (p<0.05). The age, number of cysts, Garbi scores of cysts, the rate of recurrent cysts, the level of preoperative bilirubin, alkalene phosphatase, and transaminases were similar in both groups (p>0.05). GGT was significantly different between two groups (p<0.05). The cystotomy + drainage, cystotomy + omentopexy, and intracystic biliary suture rates were similar in both groups. Postoperative non biliary complications were determined in 4 (7.5%) patients in group A and 7 patients (46.7%) in group B (p<0.05). Hospital stay was longer in group B significantly (p<0.05). CONCLUSIONS In conclusion, GGT as a laboratory [corrected] test for predicting occult CBC preoperatively have been shown to be useful in the clinical practice. However, larger prospective studies are needed on this subject. Occult cysto-biliary fistulas can only be exposed during surgery when suspected by a surgeon. If occult CBC is found, the opening in the biliary system should be sutured with absorbable material, with or without cystic duct drainage. If no biliary opening is found, cystic duct drainage may be performed if preoperative factors predict the presence of CBC. As the development of external biliary fistulas increases the morbidity and the hospitalization period, novel surgical methods to prevent the development of bile fistulas are required in such patients. |
| Starting Page | 315 |
| Ending Page | 320 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 21611113v1 |
| Volume Number | 8 |
| Journal | International journal of medical sciences |
| Alternate Webpage(s) | http://www.medsci.org/v08p0315.pdf |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Bile duct structure Bile fluid Biliary Atresia Biliary Fistula Biliary tract structure Bilirubin Bilirubin, direct measurement Collecting Duct Carcinoma of the Kidney Complete Blood Count Cyst Cystic duct structure Cystotomy Description Echinococcosis Extrahepatic Bile Duct Mucinous Adenocarcinoma Gamma glutamyl transferase measurement Hospitalization Icterus Large Liver diseases Liver neoplasms Morbidity - disease rate Omentopexy Patients Postoperative Complications Suture Device Component Tracheoesophageal Fistula Transaminases cbc diff pathologic fistula |
| Content Type | Text |
| Resource Type | Article |
