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01-05-2020 | Echinococcosis | Original Article

A serious complicatıon of liver hydatid cysts in children: cystobiliary fistulas

Authors: Sabri Demir, Gülsah Bayram Ilikan, Ahmet Erturk, Can I. Oztorun, Dogus Guney, Mujdem Nur Azili, Emrah Senel, H. Tugrul Tiryaki

Published in: Pediatric Surgery International | Issue 5/2020

Abstract

Aim

We aimed to determine predictive factors for predicting cystobiliary fistulas (CBF) in children after treatment of liver hydatid cyst (LHD).

Methods

The records of patients who were treated for LHD between 01.06.2009 and 1.06.2019 were retrospectively reviewed. Age, sex, laboratory test results, size and number of cysts, method of first intervention (percutaneous or surgery), whether or not CBF developed and how it was treated were investigated. Among findings, those could be predictive were investigated. Data were evaluated with SPSS 21.0 program, p < 0.05 was considered significant.

Results

Of the 97 patients, 48 (49.5%) were male, 49 (50.5%) female, the mean age was 11.2 years, Eighty patients had right (82.5%), 13 had left, and 4 had bilobar involvement. As first intervention, surgery was performed in 39 (40.2%); percutaneous treatment was performed in 58 (59.8%) patients. In 8 patients (20.5%) in surgery group and in 6 patients (10.3%) in percutaneous group, totally in 14 patients (14.4%), CBF developed. The mean cyst diameter of CBF-developed group was 114.36 mm, and of CBF-undeveloped group was 74.30 mm. There was no statistically significant differences between groups in terms of age, sex, involved lobe, other organ involvement, and preoperative results (p > 0.5). There was a significant relationship between the cyst diameter and the rate of CBF development in both surgical and percutaneous groups (p < 0.05). ROC analysis was performed, and the cut-off value for the development of CBF detected as 69 mm for children. Since obstructive jaundice seen in adults is not common in children, an increase in liver function tests and bilirubin levels were not seen in our patients.

Conclusion

A significant correlation was found only between the size of the cyst and developing CBF. Cysts greater than 69 mm have a higher risk of developing CBF after both percutaneous and surgical treatment and should be closely monitored.

Moro P, Schantz PM (2009) Echinococcosis: a review. Int J Infect Dis 13(2):125–133CrossRef

Yilmaz M, Akbulut S, Kahraman A, Yilmaz S (2012) Liver hydatid cyst rupture into the peritoneal cavity after abdominal trauma: case report and literature review. Int Surg 97(3):239–244CrossRef

Akbulut S (2018) Parietal complication of the hydatid disease: comprehensive literature review. Med Baltimore 97(21):e10671CrossRef

Demircan O, Baymus M, Seydaoglu G, Akinoglu A, Sakman G (2006) Occult cystobiliary communication presenting as postoperative biliary leakage after hydatid liver surgery: are there significant preoperative clinical predictors? Can J Surg 49(3):177–184PubMedPubMedCentral

Chopra N, Gupta V, Rahul KS, Joshi P, Gupta V, Chandra A (2018) Liver hydatid cyst with cystobiliary communication: laparoscopic surgery remains an effective option. J Minim Access Surg 14(3):230–235CrossRef

Tiryaki TH, Akbıyık F, Mambet E, Livanelioğlu Z, Atayurt H (2009) Are biliary complications really seen less in children with hydatid liver disease? Turk J Pediatr Dis 3(4):34–39

Tsimoyiannis EC, Siakas P, Glantzounis G, Tsimoyiannis JC, Karayianni M, Gossios KJ (2000) Intracystic pressure and viability in hydatid disease of the liver. Int Surg 85(3):234–236PubMed

El Nakeeb A, Salem A, El Sorogy M, Mahdy Y, Ellatif MA, Moneer A, Said R, El Ghawalby A, Ezzat H (2017) Cystobiliary communication in hepatic hydatid cyst: predictors and outcome. Turk J Gastroenterol 28(2):125–130CrossRef

Yalin R, Aktan AO, Yeğen C, Döşlüoğlu HH (1992) Significance of intracystic pressure in abdominal hydatid disease. Br J Surg 79(11):1182–1183CrossRef

10.

Dolay K, Akbulut S (2014) Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease. World J Gastroenterol 20(41):15253–15261CrossRef

11.

Lee HC, Yeung CH, Chang PY, Sheu JC, Wang NL (2000) Dilatation of the biliary tree in children: sonographic diagnosis and its clinical significance. J Ultrasound Med 19(3):177–182CrossRef

12.

Atahan K, Küpeli H, Deniz M, Gür S, Cökmez A, Tarcan E (2011) Can occult cystobiliary fistulas in hepatic hydatid disease be predicted before surgery? Int J Med Sci 8(4):315–320CrossRef

13.

Jegadeesh S, Mahajan JK (2016) Occult cysto-biliary communication: a forgotten complication of hepatic hydatidosis. J Indian Assoc Pediatr Surg 21(4):206–207CrossRef

14.

Saylam B, Coşkun F, Demiriz B, Vural V, Comçali B, Tez M (2013) A new and simple score for predicting cystobiliary fistula in patients with hepatic hydatid cysts. Surgery 153(5):699–704CrossRef

15.

Toumi O, Ammar H, Gupta R, Ben Jabra S, Hamida B, Noomen F, Zouari K, Golli M (2019) Management of liver hydatid cyst with cystobiliary communication and acute cholangitis: a 27-year experience. Eur J Trauma Emerg Surg 45:1115–1119CrossRef

16.

Kilic M, Yoldas O, Koc M, Keskek M, Karakose N, Ertan T, Gocmen E, Tez M (2008) Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter? Am J Surg 196(5):732–735CrossRef

17.

Trigui A, Rejab H, Akrout A, Fendri S, Toumi N, Kachaou A, Jemal A, Amar MB, Mzali R (2019) Predictive factors of occult cystobiliary fistula after conservative surgical treatment of the hepatic hydatid cyst: a retrospective study of 105 patients. Ann Ital Chir 90:52–56PubMed

18.

Unalp HR, Baydar B, Kamer E, Yilmaz Y, Issever H, Tarcan E (2009) Asymptomatic occult cysto-biliary communication without bile into cavity of the liver hydatid cyst: a pitfall in conservative surgery. Int J Surg 7(4):387–391CrossRef

19.

Daradkeh S, El-Muhtaseb H, Farah G, Sroujieh AS, Abu-Khalaf M (2007) Predictors of morbidity and mortality in the surgical management of hydatid cyst of the liver. Langenbecks Arch Surg 392(1):35–39CrossRef

20.

Atli M, Kama NA, Yuksek YN, Doganay M, Gozalan U, Kologlu M, Daglar G (2001) Intrabiliary rupture of a hepatic hydatid cyst: associated clinical factors and proper management. Arch Surg 136(11):1249–1255CrossRef

Title: A serious complicatıon of liver hydatid cysts in children: cystobiliary fistulas
Authors: Sabri Demir
Gülsah Bayram Ilikan
Ahmet Erturk
Can I. Oztorun
Dogus Guney
Mujdem Nur Azili
Emrah Senel
H. Tugrul Tiryaki
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Echinococcosis
Cystectomy
Endoscopic Retrograde Cholangiopancreatography
Published in: Pediatric Surgery International / Issue 5/2020
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04637-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A serious complicatıon of liver hydatid cysts in children: cystobiliary fistulas

Abstract

Aim

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Aim

Methods

Results

Conclusion

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