Surgical treatment of intrabiliary rupture of hydatid cysts of liver: Comparison of choledochoduodenostomy with T-tube drainage

Background. Intrabiliary rupture is one of the most serious complications o f liver hydatid cysts (LHC). The kind of surgery for these patients is stil l controversial. T-tube drainage and choledochoduodenostomy (CD) are used b y most of the surgeons. But there is no comparative study in the literature . Methods: Eighty patients with symptomatic intrabiliary rupture were treat ed between 1980 and 1995. All patients had jaundice. In addition to treatme nt of the cyst cavity, T-tube drainage of the common bile duct (CBD) was pe rformed in 53 patients, 25 patients underwent a CD for biliary drainage and two patients were treated by a T-tube placed in the CBD without treating t he cyst. The T-tube drainage and CD groups were compared in regard to morbi dity, mortality, duration of the operation, rate of relaparatomy and durati on of postoperative hospital stay. Results: The morbidity rate was 40% (10/ 25) after CD and 18.1% (10/55) after T-tube drainage. Relaparatomy was nece ssary in 8% (2/25) and 1.8% (1/55) of patients treated with CD and T-tube d rainage, respectively. T-tube drainage was performed much more rapidly than CD (p < 0.05). The length of hospital stay for both groups was the same. O ne patient who was treated with CD died postoperatively. Conclusion: Our re sults suggest that T-tube drainage is superior to CD for intrabiliary ruptu re of LHC in most cases. Copyright (C) 2001 S. Karger AG, Basel.