Intrabiliary rupture: An algorithm in the treatment of controversial complication of hepatic hydatidosis

Table 1 Patients’ characteristics (n = 8).

Mean age	52.12±18.26
Female/male	1/7
Symptoms
Right upper quadrant pain, palpable hepatic mass, flatulence	8
Cholestatic jaundice	4
Number of cysts
1	4
2	2
3 or more	2
Stages of cysts (According to Gharbi’s classification) Stage II	3
Stage III	5
Choledochal image at US and CT-scan dilated ( = 2 cm)	3
Normal	5

Table 2 Objectives of the cysts and diagnostic investigations.

Patient number	ALT, AST, ALP levels	Bilirubin levels (total/conj mg/dL)
1	High	7/5
2	N	N
3	N	N
4	N	N
5	High	5/3
6	High	5/3
7	High	11/8
8	N	N

Table 3 Diagnosis and treatment of cystobiliary fistulae.

Patient number	Clinical and diagnostic characteristics of the patients	Treatment of common bile duct
1	Evidence of obstructive jaundice with cystic contents in large CBD	Choledochoduodenostomy
2	Bile stained cystic liquid and visible orifice	Suturing orifice
3	Bile stained cystic liquid and visible orifice	Suturing orifice
4	Bile in cystic liquid	T-tube drainage
5	Evidence of obstructive jaundice, invisible orifice, normal caliber choledochus (postop biliary leakage)	Percutaneous drainage under US guidance post-operatively
6	Evidence of obstructive jaundice with cystic contents in a large CBD	Choledochoduodenostomy
7	Evidence of obstructive jaundice, hemobilia, enlargement of the CBD with cystic content	T-tube drainage
8	No suspicion of intrabiliary rupture	ERCP and sphincteroplasty