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Biliary fistula and late recurrence of liver hydatid cyst:Role of cystobiliary communication:A prospective multicenter study

查看全文 作　　者：Tamer A A M [1]Habeeb;Mauro [2]Podda;Boris [3]Tadic;Vishal G [4]Shelat;Yaman [5]Tokat;Mohamed Ibrahim Abo [6]Alsaad;Abd-Elfattah [7]Kalmoush;Mohammed Shaaban [7]Nassar;Fawzy Metwally [7]Mustafa;Mahmoud Hassib Morsi [7]Badawy;Mohamed Sobhy [7]Shaaban;Tarek Zaghloul [7]Mohamed;Mohammed Ibrahim El Sayed [7]Henish;Hamdi [8]Elbelkasi;Mahmoud Abdou [1]Yassin;Abdelshafy [1]Mostafa;Amr [1]Ibrahim;Waleed A-[1]Abdelhady;TamerMohamed [1]Elshahidy;Mohamed Ibrahim [1]Mansour;Adel Mahmoud [1]Moursi;Mohamed Abdallah [1]Zaitoun;EhabShehata Abd-[1]Allah;Ashraf Abdelmonem [1]Elsayed;Rasha S [1]Elsayed;Ahmed M [1]Yehia;Amr [1]Abdelghani;Mohamed [1]Negm;Heba Alhussein Abo-[1]Alella;Mostafa M [1]Elaidy 高影响力作者 机构地区：[1]Department of General Surgery,Faculty of Medicine Zagazig University,Sharkia 44511,Egypt;[2]Department of Surgical Science,University of Cagliari,Cagliari 09126,Italy;[3]Clinic for Digestive Surgery–First Surgical Clinic,University Clinical Centre of Serbia,Belgrade 11000,Serbia;[4]Department of General Surgery,Tan Tock Seng Hospital,Singapore 018971,Singapore;[5]Department of Liver Transplantation and Hepatobiliary Surgery,Istanbul,Turkey,International Liver Center,and Acibadem Hospital Group,Istanbul 34000,Turkey;[6]Department of General Surgery,Faculty of Medicine-Merit University,Sohag 82511,Egypt;[7]Department of General Surgery,Faculty of Medicine,Al-Azher University,Cairo 11765,Egypt;[8]Department of General Surgery,Mataryia Teaching Hospital,Cairo 11765,Egypt高影响力机构 出　　处：《World Journal of Methodology》索引2023年第13卷第4期,共15页高影响力期刊 摘　　要：BACKGROUND Hydatid cyst disease(HCD)is common in certain locations.Surgery is associated with postoperative biliary fistula(POBF)and recurrence.The primary aim of this study was to identify whether occult cysto-biliary communication(CBC)can predict recurrent HCD.The secondary aim was to assess the role of cystic fluid bilirubin and alkaline phosphatase(ALP)levels in predicting POBF and recurrent HCD.AIM To identify whether occult CBC can predict recurrent HCD.The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD.METHODS From September 2010 to September 2016,a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty.Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence.RESULTS There was a highly statistically significant association(P≤0.001)between cystic fluid biochemical indices and the development of biliary complications(of 16 patients with POBF,15 patients had high cyst fluid bilirubin and ALP levels),where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications.There was a highly statistically significant association(P≤0.001)between biliary complications,biochemical indices,and the occurrence of recurrent HCD(of 30 patients with recurrent HCD,15 patients had high cyst fluid bilirubin and ALP;all 16 patients who had POBF later developed recurrent HCD),where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts,respectively.CONCLUSION Occult CBC can predict recurrent HCD.Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD. 关 键 词：Cysto-biliary communication Echinococcus granulosus Hydatid disease recurrence Hydatid fluid analysis LAPAROSCOPY
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