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 inour 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 inAl-Sader teaching hospital in Al-Najaf city, from October 2015 to April 2019. A total of 43 patients whounderwent surgery complicated with persistent leakage of bile from externaldrain. Prospectively collecteddatabase were gathered from patients medical records,sent for essential investigations, and treated eitherconservatively 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 241patients(17,8 %),230 patients treated with conservative surgery (95,4 %), 2 patients treated with radicalsurgery(0,82 %) and 9 patients treated with percutaneous aspiration injection reaspiration (3.7%).All the 43patients in this search treated with conservative surgery. Size more than 15 cm is a risk factors. Intraoperativerisk factor is mainly presence of cystobiliary communication which occur in 16 patients (37,2%). Treatment;isconservative in about 23 patients(53.4%).Treatment with ERCP in 19 patients (44.1%).Time of interventionis from 9 – 15 days.Conclusion: Most of patient with external biliary fistula after hydatid liver surgery can be treatedconservatively and resolve spontaneously specially low output fistula.