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Cholecysto-hydatid cyst fistula
Anand Kumar1, Divya Narain Upadhyaya, Seema Singh
1Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005. anand_bhu@satyam.net.in
Summary
Recurrent hydatid liver disease in a young woman was treated with surgery and a novel technique. A combination of partial pericystectomy, cholecystectomy, and percutaneous treatment effectively managed liver cysts.
Area of Science:
- Hepatobiliary surgery
- Parasitology
- Medical imaging
Background:
- Hydatid liver disease, caused by Echinococcus granulosus, can present with recurrent or complex cystic formations.
- Surgical and medical management strategies are continually evolving for complex hepatic echinococcosis.
Observation:
- A 27-year-old female patient presented with recurrent hepatic hydatid cysts.
- Computed tomography (CT) revealed unilocular cysts in liver segments IV and VII.
- Intraoperative findings identified a fistulous connection between the gallbladder and the cyst in segment IV.
Findings:
- The cyst in segment IV was managed with partial pericystectomy and cholecystectomy.
- The cyst in segment VII was treated using percutaneous aspiration, instillation of hypertonic saline, and re-aspiration (PAIR).
- Post-procedural treatment included albendazole administration.
Implications:
- This case highlights a successful combined surgical and percutaneous approach for managing complex recurrent hydatid liver disease.
- The findings suggest that tailored treatment strategies, considering cyst location and associated pathologies like fistulous communications, are crucial.
- This approach may offer an effective alternative for complex hepatic echinococcosis, potentially reducing recurrence rates.