[Intrabiliary XXXX of hepatic hydatid cysts: results of 17 years' experience].

@entity1 @entity82 @entity295 @entity16221 @entity1157 @entity1151 @entity397 @entity292 @entity86 @entity3116
Between 1990 and 2006 in the III-rd Surgical Clinic Cluj-Napoca, 366 pacients with hepatic hydatid cyst were admitted and underwent surgery; 81 (22.13%) of them, who had a cyst-biliary comunication, were retrospectively reviewed: 52 (64.2%) had an occult communications and 29 (35.8%) had a @entity397 . The sex ratio was M/F=46/35 with a mean age of 44.5 years and with ages between 17 and 73 years. Choledochotomy, evacuation of parasitic material and lavage of the @entity16221 were performed in all @entity1 with @entity397 . In 25 @entity1 , partial pericystectomy and choledochoduodenostomy/T-tube drainage of @entity16221 was performed. Internal drainage by a Roux-en-Y pericystectojejunostomy and biliodigestive anastomosis was carried out in 2 @entity1 , while other two @entity1 underwent external drainage of cystic cavity and T-tube drainage of @entity16221 . 15 @entity1 (51.7%) had postoperative external @entity1157 ( @entity292 ). Occult communications were managed by partial pericystectomy +/- narrowing of the residual cavity (capitonage with an omentum flap or invagination of the @entity82 capsule margins into the cavity) in 35 @entity1 (67.3%) while in 10 @entity1 (19.2%) internal drainage by a Roux-en-Y pericystectojejunostomy was carried out. Regional resection of the liver was performed in 4 cases (7.7%) and external drainage of residual cavity in 3 @entity1 (5.7%). 13 @entity1 (25%) had postoperative external @entity1157 ( @entity292 ). The mean postoperative hospitalisation was 20 days with the range 5-85 days. The mortality rate was 2.4% (2 @entity1 ): one died due to @entity295 and MOFS and the other due to @entity1151 . CONCLUSION: @entity86 ( @entity292 ) fallowing conservative surgery of ruptured hydatid hepatic cyst into the biliary tract are not rare regardless of the type of @entity397 (frank or occult). Although the opening of the biliary duct is sutured, the risk of @entity3116 is not clearly corelated with this approach; in such cases internal drainage provides a good alternative with low morbidity.
