Akademik Veri Yönetim Sistemi
Indian Journal of Surgery, cilt.85, sa.4, ss.823-828, 2023 (SCI-Expanded)
© 2022, Association of Surgeons of India.The aim of this study was to evaluate the effectiveness of a novel method to identify occult cystobiliary fistulas and prevent leakage. Twenty-four patients diagnosed with liver hydatid cyst who were treated in our clinic between April 2017 and December 2020 were evaluated for inclusion into the study. After opening the cyst from the dome, removing the cyst contents, and performing cholecystectomy, the entire biliary tree was filled with parenteral lipid solution through a catheter inserted in the cystic duct (Omegaven® 10%, Fresenius Kabi) in order to evaluate occult and repaired fistulas. Thirteen (65%) of the 20 patients included in the study were female and seven (35%) were male. Twelve (60%) patients had solitary lesions, and eight (40%) patients had multiple cysts. Bile contamination was observed in the cyst cavity during cystotomy in nine (45%) patients. In two (10%) patients, bile contamination was observed in sponges placed in the cavity following cyst evacuation. Bile leakage was not observed in the intra- or postoperative periods in any of the patients as a result of repairs involving the application of a pressurised lipid solution to the bile tree through a catheter in the cystic duct. The technique applied in this article made it possible to detect all fistulas between the cyst and biliary tract during surgery and to check our results after completion of necessary repairs. Although the results of our study are positive, many studies are now needed on this subject.