HYDATID CYST OF THE LIVER RUPTURED INTO THE BILIARY TRACT: SERIES OF 52 CASES

The rupture of the hydatid cyst in the bile ducts is a frequent and serious complication whose evolution of the disease which from parasitic becomes hepatobiliary and involves the vital prognosis. The aim of our work is to review the clinical and therapeutic aspects of this complication. For this, we conducted a retrospective study of operated cases of ruptured hydatid cyst in the bile ducts. Between January 2015 and December 2022, 52 cases of hydatid cyst of the liver ruptured in the bile ducts were collected in our department, these are 30 women and 22 men, with an average age of 38.6 years with extremes between 18 and 70 years old. The clinical picture was marked in the majority of cases by an association of hepatic colic (84%), jaundice (28%), febrile syndrome (13%) and episodes of cholangitis in 8% of cases. Clinical examination found hepatomegaly in 25% of cases. The fistula between the cyst and the bile ducts was incidentally discovered in 2% of cases. The contribution of radiological examinations, in particular ultrasound, is invaluable, supplemented in case of doubt by computed tomography. The treatment of the cyst consisted of conservative treatment in most patients 71.15%, pericystectomy in 23.07%. This conservative treatment was completed by suture of the cystobiliary fistula 67.30%, catheterization 3.84%, Perdomo technique 13.46%, drainage of the main bile duct in 57.69% of cases, a bipolar drainage in 2 cases and finally a case of bilio-digestive anastomosis. The surgical procedure was radical in 3 cases. There was no known recurrence or late complications (jaundice) in the patients followed regularly in 82.69% of cases, while 11.53% patients presented postoperative complications.