[Internal trans-Oddi's sphincter fistula drainage of hydatid cysts communicating with the bile ducts]. / Drainage interne trans-fistulo-oddien des kystes hydatiques ouverts dans les voies biliaires.

ABSTRACT

OBJECTIVE: The purpose of this study was to examine the contribution of internal trans-fistulary drainage without opening the cystic cavity for the treatment of hydatic cyst of the liver. PATIENTS AND METHODS: Between 1985 and 1990, 14 patients with hydatid cyst of the liver communicating with the bile duct were treated by internal trans-fistulary drainage without opening the hydatic cavity. Choledocoscopy demonstrated good bile flow without a remaining cystic fragment in all cases. The residual cavity was drained via an external drain in the common bile duct. A second hydatic cyst of the liver was also treated in 4 patients. RESULTS: Internal trans-fistulary drainage was achieved easily. There were two treatment-related postoperative complications bilary leakage in one patient and infection of the residual cavity leading to septicemia and death in another. CONCLUSION: Internal trans-fistulary drainage without opening the hydatic cavity is indicated for central hydatic cyst of the liver measuring less than 15 cm with a flexible pericyst and a large biliocystic fistula measuring more than 5 mm. Peroperative choledochoscopy of the hydatic cavity is necessary.