ENDOSCOPIC TREATMENT OF LIVER HYDATID CYSTS WITH INTRA BILIARY RUPTURE

Aims Study the contribution of ERCP in the management of liver hydatid cysts with intrabiliary rupture.

Methods Retrospective study conducted in the hepato-gastroenterology department between January 2018 and November 2021 including 23 cases of intrabiliary rupture of HCL who underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic biliary sphincterotomy (EBS).

Results During period study, 905 ERCP were performed, intrabiliary rupture of HCL was indicated in 23 cases, i.e. 2.5% of indications for ERCP in our series, with a sex ratio M/F: 0,7. Clinical symptomatology was dominated by acute cholangitis in 74% of cases.

All patients had cytolysis and/or biological cholestasis. Abdominal ultrasound and abdominal CT showed bile duct dilatation in 74%, the presence of hydatid material in the common bile duct in 48% of patients. In ERCP opacification: a lacunar images in CBD were in 52% of cases. EBS was performed in all patients, with extraction of hydatid material by balloon in 13 cases and by Dormia basket in one case.

The outcome was favorable; disappearance of jaundice after an average of 6 to 12 days.

Surgery in post ERCP has been indicated in 9 patients with a good outcome.

Conclusions In our study, endoscopic drainage of intrabiliary rupture of hydatid cysts represents 2.5% of the indications for ERCP. For this reason, endoscopic sphincterotomy constitutes a therapeutic advance in the biliary complications of hepatic hydatid cyst which is a safe and effective therapy with low morbidity and mortality.

Publication History

Article published online:
14 April 2022