The Etiologies of Biliary Fistula Following Open Resection of Hepatic Hydatid Cyst

Hydatidosis is a protozoal disease caused by Echinococcus granulosus, and presents as an endemic disease in Iran. Hepatic hydatid cyst is the most common involved body organ that requires surgical cyst resection in case of being symptomatic. Among most serious complications of hydatid cyst surgery is biliary fistula. The current study aimed to assess the etiologic factors of biliary fistula incidence. This was a census retrospective cross-sectional study conducted on 69 patients underwent open hydatid cyst resection in Alzahra hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during the years 2015-18. Patients' information including age, gender, previous history of hepatic surgery, cyst diameter, cyst location, and serum level of alkaline phosphatase (ALP) prior to surgery were recorded. Then, patients were followed considering the incidence of biliary fistula. Association of mentioned factors with biliary fistula occurrence was assessed. 15 patients (21.7%) presented biliary fistula. No statistical association was found between the incidence of biliary fistula and gender (P = 0.08), age (P = 0.75), position of hydatid cyst (P = 0.89), hydatid cyst size (P = 0.37), previous history of surgery (P = 0.50), and serum level of ALP prior to the surgery (P = 0.26). Based on findings of the current study, no significant association was detected between the incidence of biliary fistula following open resection of hydatid cyst and factors such as age, gender, previous history of hepatic surgery, cyst size, cyst location, and serum levels of ALP. Further studies with greater study populations are recommended.