1 research outputs found
Retrospective analysis of risk factors for development of biliary fistula after liver cyst hydatid surgery
Aim: Hepatic
hydatidosis is common parasitosis in Turkey and caused by Echinococcus granulosus.
Biliary fistula is the most common complication after liver hydatid cyst
surgery. The aim of this study was to investigate an appropriate treatment
strategy for patients whose biliary fistula might develop, by revealing
variables that affect biliary fistula.Methods: A total of
118 patients who underwent liver hydatid cyst surgery were included in this
study. The following variables were analyzed between patients with biliary
fistula (group 2) and without fistula (group 1): Age, gender, hematologic and
liver function tests, and features of the cysts (type, cyst size, number, and
localization).Results: Cystobiliary fistula was detected in
19 (16%) of 118 patients. In-group 2, cyst size, white blood cell,
alkaline phosphatase and g-Glutamyl transpeptidase levels were higher than
group 1 on univariate analysis (p=0.03, p=0.008, p=0.04 and p=0.001,
respectively). In the multivariate model, only cyst diameter remained as an
independent predictor (odds ratio 0.03, 95% confidence interval 0.002 to 0.06;
p=0.03) On the receiver operating characteristic curve, the 100% sensitive,
100% specific, and optimal cutoffs of the cyst diameter were 7.5 cm, 4.0 cm and14.6
cm, respectively (The area under the receiver operator characteristic curve was
0.67).
Conclusion: Preoperative cyst size is a valuable
parameter for predicting biliary fistula. Our study suggests that cyst size
greater than 7.5 cm is a risk factor for biliary fistula