Salih KARA, Ercan KORKUT, Nurhak AKSUNGUR, Necip ALTUNDAŞ, Gürkan ÖZTÜRK

Karaciğer Hidatik Kist Ameliyatı Sonrası Biliyer Fistül Gelişiminde Risk Faktörlerinin Retrospektif Analizi

Giriş ve Amaç: Kistik ekinokokkozis (CE), Echinococcus granulosus larvalarının neden olduğu paraziter bir hastalıktır. CE benign karakterde bir hastalık olmasına rağmen komplike kistler varlığında morbiditesi yüksektir. En önemli komplikasyonlar safra yollarının fistülizasyonu ve intraperitoneal kist rüptürleridir. Materyal ve Metod: 2011-2021 yılları arasında Atatürk Üniversitesi Araştırma Hastanesi'nde CE nedeniyle ameliyat edilen hastalar geriye dönük olarak incelendi. Ameliyat edilen tüm hastaların demografik bilgileri, CE lokalizasyonu, kist boyutu, CE sınıflandırması, cerrahi teknikler ve hastanede kalış süreleri kaydedildi. Tüm veri türlerinin kategorik değişken üzerindeki etkisi ikili lojistik regresyon kullanılarak analiz edildi. Bulgular: Hastaların 299'u (%60,2) kadın, 198'i (%39,8) erkekti. Safra fistülü olan ve olmayan grupta yaş ortalamaları sırasıyla 41 ± 15.48 ve 41 ± 15.36 idi. İki grup arasında ortalama kist boyutlarında anlamlı bir fark bulduk. WHO sınıflamasına göre kist yerleşimi ve kist tipi, kistobiliyer bağlantı üzerinde istatistiksel olarak anlamlı bir etkiye sahipti (sırasıyla p: 0.00, p: 0.00. Kist tiplerine göre analiz, CE 1, CE2, CE3A ve CE3B kistlerinin biliyer üzerinde istatistiksel olarak anlamlı derecede etkili olduğunu gösterdi. fistül oluşumu CE 1 tipi kistler diğer kist tiplerine göre daha etkiliydi. CE 2, CE3A ve CE 3B kistleri CE1'e göre daha az etkiliydi. Sonuç: Sol lob yerleşimli karaciğer kist hidatiklerinde ve CE1 kistlerinde safra kaçağı riski daha fazladır. Büyük kistlerde safra kaçağı görülme sıklığı artar. Anahtar kelimeler: Kistik ekinokokkozis, Safra fistülü, Kisto biliyer fistül

Anahtar Kelimeler:

Kistik Ekinokokkozis, Safra fistülü, Kistobiliyer bağlantı

Retrospectıve Analysis Of Risk Factors In The Development Of Biliary Fistula After Liver Hydatid Cyst Surgery

Abstract Background: Cystic echinococcosis (CE) of the liver is a parasitic disease caused by the larvae of Echinococcus granulosus. Although CE is a disease with benign characteristics, its morbidity is high in the presence of complicated cysts. The most important complications are fistulization of the biliary tract and intraperitoneal cyst ruptures Material Methods: Patients who underwent surgery for CE in Atatürk University Research Hospital between 2011 and 2021 were analyzed retrospectively. Demographic information, CE localization, cyst size, CE classification, surgical techniques and hospitalization time of all operated patients were recorded. The effect of all data types on the categorical variable was analyzed using binary logistic regression. Results: Of the patients, 299 (60.2%) were female, and 198 (39.8%) were male. The mean age was 41 ± 15.48 and 41 ± 15.36 years in the group with and without bile fistula, respectively. We found a significant difference in mean cyst sizes between the two groups. Cyst location and cyst type according to WHO classification had a statistically significant effect on the cysto biliary communication (p: 0.00, p: 0.00, respectively. Analysis by cyst types showed that CE 1, CE2, CE3A, and CE3B cysts were statistically significantly effective on biliary fistula formation. CE 1 type cysts were more effective than other cyst types. CE 2, CE3A, and CE 3B cysts were less effective than CE1 Conclusion: The risk of bile leakage is higher in hepatic hydatid cysts located in the left lobe and in CE1 cysts. The incidence of bile leakage increases in large cysts.

Keywords:

Cystic echinococcosis, Bile Fistula, Cysto biliary communication,

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