Karaciğer hidatik kist cerrahisi sonrası safra fistülü: Tahmin edilebilir bir komplikasyon mu?

Amaç: Karaciğer hidatik kisti ameliyatı sonrası safra fistülü gelişimi sık bir komplikasyondur. Bu çalışmanın amacı, karaciğer hidatik hastalığı nedeniyle opere edilen hastalarda postoperatif bilyer fistül gelişimini etkileyen faktörleri incelemektir.Yöntemler: Çalışma, 1999 ve 2010 yılları arasında karaciğer hidatik kisti nedeniyle cerrahi olarak tedavi edilen hastalarda retrospektif olarak yapıldı. Hidatik kist için ameliyat edilen 53 hastanın verileri hastane kayıtları ile gözden geçirildi. Hastalar safra fistülü olan (Grup A) ve safra fistülü olmayan (Grup B) olmak üzere iki gruba ayrıldı. Yaş, cinsiyet, kist çapı, kist yerleşimi, laboratuvar testleri ve hastanede kalış süresi kaydedildi. Bu parametreler gruplar arasında karşılaştırıldı. Bulgular: Gruplar yaş ve cinsiyet açısından benzer özellikteydi (p = 0,790 ve p=1,0 sırasıyla). Grup A’daki ortalama kist çapı grup B’den anlamlı olarak büyüktü (p=0,001). Ortalama hastanede kalış süresi grup A’da grup B’den uzundu (p=0,001). Kist lokalizasyonu ve AST, ALT, total bilirubin, direk bilirubin değerleri açısından gruplar arasında fark yoktu (hepsi için p>0.05). Sonuç: Ameliyat öncesi kist çapı, safra fistülünü tahmin etmek için faydalı bir parametre olabilir. Bununla beraber, bu konuda daha geniş prospektif serilere ihtiyaç vardır.

Anahtar Kelimeler:

Kist hidatik, karaciğer, safra fistülü, ERCP

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Aim: The biliary fistula development after liver hydatid cyst surgery is a common complication. The aim of this study is to examine the factors affecting the development of postoperative biliary fistula in patients operated for liver hydatid disease. Methods: The study was retrospectively performed in patients treated surgically for liver hydatid cyst between 1999 and 2010. The data of 53 patients operated for hydatid csyt were reviewed with hospital records. Patients were divided into two groups as biliary fistulas with (Group A) and without biliary fistula (Group B). The demographic data (age, sex), cyst diameter, cyst localization, laboratory tests and length of hospital stay were recorded. These parameters were compared with the groups.Results: The groups were similar in terms of age and sex (p = 0.790 and p=1.0, respectively). In group A, the mean cyst diameter was significantly higher than group B (p=0.001). The mean duration of hospitalization was longer in group A than group B (p=0.001). There was no difference between the groups considering cyst localization, AST, ALT, total bilirubin and direct bilirubin (p>0.05 for all). Conclusion: Preoperative cyst diameter may be a valuable parameter for predicting biliary fistula preoperatively. However, larger prospective studies are needed on this subject.

Keywords:

Hydatid cyst, liver, biliary fistula, ERCP,

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