Comparison And Analysis The Effects Of Post Operative Outcomes In Intrabiliary Rupture For Hepatic Cystic Echinococcosis

Objective:To caracterise and analyse the Intrabiliary rupture (IBR) of hepatic hydatid cyst (HHC) and the treatments on postoperative complications of Intrabiliary rupture (IBR). The aim of this retrospective study was to evaluate post operative short term and long-term outcome of patients treated surgically for complicated liver hydatid cysts. Methods:A total of one hundred sixty eight cases with biliary communication of hydatid cyst were analyzed retrospectively. Of168patients with biliary communication92(54.76%) had an occult rupture while76(45.23%) had frank biliary rupture. Preoperative demography, ultrasonic cyst features, postoperative short term complications, postoperative follow up (long-term) complications and hospital stay were recorded and analyzed. Results:There were no differences in the demographic characteristics and preoperative cyst features in frank and occult group. Compared with the frank group9.34±1.25(days), the postoperative stay in occult6.97±1.24were relatively shorter (P<0.05). The incidence of overall postoperative short term complications and midterm complications were statistically and insignificantly lower in occult group (22.82%) than frank group (30.26%) with P=0.275. Incidence of post-operative biliary leakage8(8.69%) and abscess5(5.43%) in occult group was insignificantly more common then frank rupture with biliary leakage5(6.5%) and abscess2(2.63%) with p value was0.609and0.365respectively while long term biliary stricture is higher in frank group(10.52%) then occult group(0%) with P=0.01.Conclusion:Frequency of occurrence of postoperative short term complications biliary fistula and abscess is relatively more common in occult rupture with transcystic drain due to its indolent course, inability to find and suture the rupture orifice and incomplete decompression while biliary stricture is significantly more common in frank group due to its involvement of major bile ducts.