Department of General Surgery, School of Medicine, Gaziantep University, Gaziantep, Turkey.
Dig Dis Sci. 2024 Mar;69(3):961-968. doi: 10.1007/s10620-024-08284-1. Epub 2024 Feb 10.
External biliary fistula, where the residual cyst is associated with the biliary tree, is one of the most common complications after liver hydatid cyst surgery. Surgical procedures become a consideration for patients in whom the biliary fistula persists despite all endoscopic procedures. However, reoperation for biliary fistula after hydatid cyst surgery leads to additional complications and increases morbidity and mortality.
This study aims to treat persistent biliary fistulas that develop after liver hydatid cyst surgery using a simple noninvasive technique.
External drainage surgery was performed on 295 patients with liver hydatid cysts. Endoscopic treatment methods were used in patients who developed biliary fistula after surgery. Despite all endoscopic treatment methods, 14 patients developed persistent biliary fistulas. These patients were subsequently treated using the drain clamping technique.
All persistent fistulas occluded in 11.86 days (with a range of 8-20 days). No complications were observed in the one-year follow-up visits.
Drain clamping, a novel approach to the treatment of persistent biliary fistulas developed despite all available endoscopic methods, can be safely used. This technique resulted in a complete recovery in patients without the need for surgical procedures.
残余囊肿与胆道系统相关的外胆管瘘是肝包虫囊肿手术后最常见的并发症之一。对于所有内镜治疗后仍持续存在胆管瘘的患者，手术成为一种考虑。然而，肝包虫囊肿手术后胆管瘘的再次手术会导致额外的并发症，增加发病率和死亡率。
本研究旨在使用一种简单的非侵入性技术治疗肝包虫囊肿手术后出现的持续性胆管瘘。
对 295 例肝包虫囊肿患者进行了外引流手术。对手术后发生胆管瘘的患者采用内镜治疗方法。尽管采用了所有的内镜治疗方法，仍有 14 例患者出现持续性胆管瘘。随后对这些患者采用了引流管夹闭技术进行治疗。
所有持续性瘘管在 11.86 天（8-20 天）内闭塞。在为期一年的随访中未观察到任何并发症。
尽管所有现有的内镜方法都可用，但引流管夹闭作为一种治疗所有可用内镜方法后仍持续存在的胆管瘘的新方法，可以安全使用。该技术使患者无需手术即可完全康复。
