Retrospectıve Analysis Of Risk Factors In The Development Of Biliary Fistula After Liver Hydatid Cyst Surgery

Abstract

Abstract
 Background: Cystic echinococcosis (CE) of the liver is a parasitic disease caused by the larvae of Echinococcus granulosus. Although CE is a disease with benign characteristics, its morbidity is high in the presence of complicated cysts. The most important complications are fistulization of the biliary tract and intraperitoneal cyst ruptures
 Material Methods: Patients who underwent surgery for CE in Atatürk University Research Hospital between 2011 and 2021 were analyzed retrospectively. Demographic information, CE localization, cyst size, CE classification, surgical techniques and hospitalization time of all operated patients were recorded. The effect of all data types on the categorical variable was analyzed using binary logistic regression. 
 Results: Of the patients, 299 (60.2%) were female, and 198 (39.8%) were male. The mean age was 41 ± 15.48 and 41 ± 15.36 years in the group with and without bile fistula, respectively. We found a significant difference in mean cyst sizes between the two groups. Cyst location and cyst type according to WHO classification had a statistically significant effect on the cysto biliary communication (p: 0.00, p: 0.00, respectively. Analysis by cyst types showed that CE 1, CE2, CE3A, and CE3B cysts were statistically significantly effective on biliary fistula formation. CE 1 type cysts were more effective than other cyst types. CE 2, CE3A, and CE 3B cysts were less effective than CE1 
 Conclusion: The risk of bile leakage is higher in hepatic hydatid cysts located in the left lobe and in CE1 cysts. The incidence of bile leakage increases in large cysts.