Choledochoscopy in intrabiliary rupture of hydatid cyst of the liver

From 1981-1985, 62 patients have been operated upon for hydatid disease of the liver. Nine patients presented with hepatic colic, chill and fever; seven cases also showed obstructive jaundice, as their cysts had ruptured into the biliary tree. A large communication between the pericyst cavity and the bile ducts was confirmed at operation. The common bile duct was explored in all nine patients and laminated membranes and daughter cysts were found in three cases. Following this, choledochoscopy was performed. Retained membranes and a stone were revealed in one of these three patients. In two other cases from the remaining six negative explorations, laminated membranes were also found. We therefore recommend choledochoscopy not only in biliary lithiasis, but in every case of intrabiliary rupture of a hydatid cyst of the liver.