Outcome of Biliary Fistula After Liver Hydatid Cyst SurgeryHydatid cyst, biliary fistulae, Outcome, surgery.

Abstract

Background: Biliary fistula after liver hydatid cyst surgery was occur in about 17.8 percent of patients in
our center.
Objective: To study the outcome of biliary fistula regarding factors related to its causes and management.
Patients and Methodology: This is a prospective study of 241cases submitted to liver hydatid surgery in
Al-Sader teaching hospital in Al-Najaf city, from October 2015 to April 2019. A total of 43 patients who
underwent surgery complicated with persistent leakage of bile from externaldrain. Prospectively collected
database were gathered from patients medical records,sent for essential investigations, and treated either
conservatively to give a chance for spontaneous closure, or by intervention with ERCP.
Results: Forty three patients who develop postoperative biliary fistula after hydatid cyst surgery from 241
patients(17,8 %),230 patients treated with conservative surgery (95,4 %), 2 patients treated with radical
surgery(0,82 %) and 9 patients treated with percutaneous aspiration injection reaspiration (3.7%).All the 43
patients in this search treated with conservative surgery. Size more than 15 cm is a risk factors. Intraoperative
risk factor is mainly presence of cystobiliary communication which occur in 16 patients (37,2%). Treatment;is
conservative in about 23 patients(53.4%).Treatment with ERCP in 19 patients (44.1%).Time of intervention
is from 9 – 15 days.
Conclusion: Most of patient with external biliary fistula after hydatid liver surgery can be treated
conservatively and resolve spontaneously specially low output fistula.