ENDOSCOPIC SPHINCTEROTOMY IN THE TREATMENT OF POSTOPERATIVE BILIARY FISTULAS OF HEPATIC HYDATID-DISEASE

Background: Ten patients with postoperative external biliary fistula t reated by endoscopic sphincterotomy are reported. Methods: Nine of the se patients were operated for hepatic hydatid disease and one for a li ver abscess. Mean daily output of bile through the fistulae which were present for 5-39 days was approximately 500 cc. Results: Treatment wa s successful in nine patients with closure of the fistulae in 2-15 day s (mean, 7 days), No response was obtained in one patient who was reop erated, and an intrahepatic biliary duct was found to be completely er oded by the cyst wall. Conclusions: Endoscopic sphincterotomy should b e the first-line treatment for postoperative external biliary fistulae related to hepatic hydatid disease.