Endoscopic sphincterotomy in the treatment of postoperative biliary fistulas of hepatic hydatid disease.

Abstract

Ten patients with postoperative external biliary fistula treated by endoscopic sphincterotomy are reported. Nine of these patients were operated for hepatic hydatid disease and one for a liver abscess. Mean daily output of bile through the fistulae which were present for 5-39 days was approximately 500 cc. Treatment was successful in nine patients with closure of the fistulae in 2-15 days (mean, 7 days). No response was obtained in one patient who was reoperated, and an intrahepatic biliary duct was found to be completely eroded by the cyst wall. Endoscopic sphincterotomy should be the first-line treatment for postoperative external biliary fistulae related to hepatic hydatid disease.