ENDOSCOPIC TREATMENT OF COMPLICATIONS OF HYDATID CYSTS IN THE LIVERBROKEN IN THE BILE DUCTS: EXPERIENCE OF A MOROCCAN SERVICE

Aims The hydatid cyst of the liver (KHF) is a parasitic disease due to the development ofthe larval form of the taenia of the dog Echinococcus granulosus. By its clinical latency, the Diagnosis is most often at the stage of complications. Fistulization of the cyst hydatid in the bile ducts is the most common complication.endoscopy is necessary because of the therapeutic problems and risks associated withsurgery. The objective of our study was to evaluate and analyze the effectiveness of ERCPin the diagnosis and treatment of hydatid cysts of the liver broken in the pathways ducts.

Methods This is a 17-year retrospective and descriptive study, ranging from January 2002 to Marsh 2019, focused on patients with fistulized KHF in the pathways Bile. ERCP and endoscopic biliary sphincterotomy were performed in all patients, 18 times preoperatively and 21 times postoperatively.

Results 50 patients with ruptured KHF in the biliary tract, 2.4% of the indications ERCP in our series were included. The average age of patients was 47, with male predominance in 65% of cases. KHF broken in the ways galls were complicated by persistent external biliary fistula post operativelyin 34% of cases. Sphincterotomy was performed in all patients allowing removal of hydatid material by extraction balloon or Dormia basketNevertheless, 21.7% required naso-biliary drainage and 8.7% benefited from the placement of a biliary prosthesis. Overall success was 100% and no complication related to endoscopic treatment was objectified. The evolution was marked by the disappearance of jaundice after 5 to 12 days inaverage after endoscopic gesture and dryness of external biliary fistulaafter 10 to 12 days.

Conclusions The results of our study confirm the efficacy and safety of ERCP and the endoscopic sphincterotomy in biliary complications of echinococcosis hepatic. It makes it possible to shorten the post-operative stay and to avoid areoperation, often difficult and haemorrhagic