The use of ERCP in the study of patients with hepatic echinococcosis before and after surgical intervention

Abstract

Background: Biliary tree involvement is the most common complication of hydatid liver disease, which is difficult to detect and manage. Methods: During the last 7 years, we examined by ERCP 26 cases with echinococcal liver involvement. Indications in the preoperative group included cholangitis in 6 cases, right-sided hypochondralgia involving 4, preoperative assessment in 4, and icterus in 1 case. In the postoperative group, the indications for ERCP were cholangitis in 5 cases, external biliary fistulas in 5, and biliary colic in 1 case. Results: ERCP findings in the preoperative group included external bile duct compression in 11 cases (73.3%), biliary fistula affecting 3 (20%), and echinococcal remnants within the common bile duct in 1 case (6.6%). With regard to the postoperative group, biliary fistula formation was detected in 6 cases (54.5%), echinococcal remnants within the common bile duct in 4 (36.3%), and external bile duct compression involving 1 case (9%). Endoscopic sphincterotomy was successfully performed in 13 patients in both groups. No serious complications were encountered. Conclusion: ERCP is a safe and helpful preoperative or postoperative tool that aids in the diagnosis and often the treatment of echinococcal liver disease with involvement of the bile ducts. (Gastrointest Endosc 1996;43:575-9)