Predictive factors of morbidity after surgical treatment of hydatid cyst of the liver

Hepatic hydatid cyst is a major health problem in endemic areas. Surgery is still the best choice for treatment of the hydatid cyst of the liver. However, it is still associated with high mortality and morbidity. The aim of the study was to evaluate the predictive factors for specific morbidity after conservative surgical treatment of the hydatid cyst of the liver. A total of 120 patients who underwent conservative surgical treatment between 2001 and 2011 were evaluated retrospectively. Of the 120 patients, 64 were female subjects and 56 male subjects; the median age was 33 years [14-83 years]. The mortality rate was 0%. The overall morbidity rate was 26.6%. The specific morbidity rate was 16.6%. The major specific complications were infection of the residual cavity in 10 cases and an external biliary fistula in eight cases. The predictive factors of morbidity in univariate analysis were bilious cyst content, location of the cyst in the hepatic dome, and size >10 cm. After multivariate analysis, only the size of the cyst was an independent predictive factor of morbidity. The size of the cyst was the significant predictor of morbidity of conservative surgery for liver hydatid cyst

[Transcystique decompression after laparoscopic exploration of common bile duct: an efficient and safe method]

Laparoscopic exploration is one of the modalities of treatment of choledocolithiasis. Modalities of biliary decompression after laparoscopic common bile duct exploration are controversial to assess the benefits, the efficacity and harms of trancystic biliary drainage following laparoscopic common bile duct stone exploration. We report retrospectively twenty patients which were operated in our department by laparoscopy and have done a transcystic biliary drainage. The mean age was 52 years. They were twenty patients [13 women and 7 men]. The median operating time was 165 minutes. Post operative course was uneventful in 17 cases. Biliary complications were present in three patients [2 biliary fistulas and one biliary peritonitis. Residual stones were found in two cases. One of the residual stone was treated with endoscopic sphincterotomy. There were no post operative deaths. There were no biliary stricture and no recurrent ductal stones. Despite of our short experience, the transcystic biliary drainage following laparoscopic management for choledocolithiasis seems to be a safe and an efficient method