[Treatment of hydatid bilio-bronchial and bilio-pleuro-bronchial fistulas by thoracotomy].

Abstract

STUDY AIM:

The aim of this study was to report the results of surgical treatment of hydatid bilio-bronchial et bilio-pleuro-bronchial fistulas via thoracotomy.

MATERIAL AND METHODS:

From 1990 to 1998, 63 cases were observed in the same center. Biliptysis was the main symptom in 72% of cases. The diagnosis was based on chest radiography and abdominal ultrasonography; both examinations visualised the cyst, intrathoracic collections, a diaphragmatic breach and biliary lesions. All patients were treated by one-stage thoracotomy. The procedures consisted of lung resection (lobectomy and/or segmentectomy) (n = 47) and decortication (n = 16) in the chest, cyst dome resection (n = 61) or partial pericystectomy (n = 12) in the abdomen and suture of the diaphragmatic defect in all cases after hepato-diaphragmatic disconnection. An additional laparotomy was necessary in 4 cases.

RESULTS:

There were 8 deaths (12.7%): one intraoperative death due to haemorrhage and seven postoperative deaths, mostly related to pulmonary complications. Postoperative complications (14.3%) were mainly respiratory. Clinical and radiological results were good with a one-year follow-up.

CONCLUSION:

Bilio-bronchial and bilio-pleurobronchial fistulas due to hydatid cyst are rare, but severe diseases. They are responsible for lesions at three levels: abdominal, diaphragmatic and thoracic. A high perioperative mortality rate was observed. Thoracotomy is the best approach for surgical treatment at all three levels.

• Authors: H Kabiri, A Chafik, S al Aziz, A el Maslout, A Benosman
• Journal: Annales de chirurgie (Ann Chir) Vol. 125 Issue 7 Pg. 654-9 (Sep 2000) ISSN: 0003-3944 [Print] France
• Vernacular Title: Traitement des fistules biliobronchiques et bilio-pleuro-bronchiques d'origine hydatique par thoracotomie.
• PMID: 11051695 (Publication Type: English Abstract, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Biliary Fistula (pathology, surgery)
• Bronchial Fistula (pathology, surgery)
• Child
• Echinococcosis (complications)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Retrospective Studies
• Thoracotomy (methods)
• Treatment Outcome