Endoscopic retrograde cholangiography and sphincterotomy for complicated hepatic hydatid cyst

We report on the results of 20 endoscopic cholangiographies indicated for hepatic hydatid disease: 14 for pre-operative investigation and 6 for post-surgical complications. In 4 out of 14 cases, endoscopic retrograde cholangiography (ERC) was not an effective procedure for the pre-operative diagnosis of complicated hepatic hydatid cyst in the biliary tract. Endoscopic sphincterotomy was performed without complications in 9 patients and permitted pre- or post-surgical removal of intrabiliary hydatid fragments in 6, successful treatments of 2 post-surgical external biliary fistulae and in association with transhepatic drainage, improvement of the clinical and biological course of one case of secondary sclerosing cholangitis. Endoscopic sphincterotomy might be indicated not only in the case of ERC diagnosis of complicated hepatic hydatic cyst, but also in the case of isolated cholangitis in patients with hepatic hydatid disease, and for complications of surgical treatment.