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

作　　者：Tamer A A M Habeeb Mauro Podda Boris Tadic Vishal G Shelat Yaman Tokat Mohamed Ibrahim Abo Alsaad Abd-Elfattah Kalmoush Mohammed Shaaban Nassar Fawzy Metwally Mustafa Mahmoud Hassib Morsi Badawy Mohamed Sobhy Shaaban Tarek Zaghloul Mohamed Mohammed Ibrahim El Sayed Henish Hamdi Elbelkasi Mahmoud Abdou Yassin Abdelshafy Mostafa Amr Ibrahim Waleed A-Abdelhady TamerMohamed Elshahidy Mohamed Ibrahim Mansour Adel Mahmoud Moursi Mohamed Abdallah Zaitoun EhabShehata Abd-Allah Ashraf Abdelmonem Elsayed Rasha S Elsayed Ahmed M Yehia Amr Abdelghani Mohamed Negm Heba Alhussein Abo-Alella Mostafa M Elaidy 

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

出　　处：《World Journal of Methodology》2023年第4期272-286,共15页世界方法学杂志

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 

分 类 号：R73[医药卫生—肿瘤]