Clinical presentation, diagnosis and surgical treatment of intrabiliary ruptured hydatid disease of the liver

Abstract

Background: Intrabiliary rupture (IBR) of liver hydatid cyst is common and serious and fatal complication. The incidence of (IBR) varies from 1% to 25%. The treatment of IBR is still controversial among surgfons. We aimed to show clinical presentations, diagnosis treatment and outcome of IBR in liver hydatid cysts by reviewing our cases. Method: In a retrospective study we collected data of records of all patients who were operated on for hydatid disease of the liver operated between 2016 and 2021 at Razi teaching and privat Arya Hospital were review. 322 patients who had been operated for hydatid cyst of the liver were detected. Approval for this study was obtained from our Institutional Review Board. Results: Intrabiliary ruptured hydatid cysts of the liver was determined in 14 of the patients was in frank IBR and 32 patient with occult IBR was determined in 322 patients was operated for hydatid cysts of the liver. The average age of patients was 28 to 64 years (range 21 - 68 years). . The most frequent symptoms were right upper quadrant,epigastric pain, dyspepsia, jaundice,fever,wight loss and pruritus Conclusions: Intrabiliary ruptured hydatid cysts of the liver is the most common complication. With appropriate evaluation and intervention, this will lead to decresed postoperative bile leakage and fistula formation, a major cause of morbidity and mortality.Every effort should be made to detect and prevent these complications,ERCPand MRCPcan hellpfor diagnosis and treatmen or IBR .Laparatomy, choledochal exploration should be performed during operation. For decompress intrabiliary pressure T-tube drainage may be preferred in the management of intrabiliary ruptured hydatid cysts because of deresed morbidity, the ability to, easier monitoring of the biliary drainage.