SURGICAL-TREATMENT OF BILE CYSTIC FISTULA WITH AN HYDATIC ORIGIN - ABOUT 83 CASES

The high number of BCF (10-24 %) descases with its direct link on post -surgical casualties require a very well structured therapy. A study o ver a period of 17 yeors on 479 patients, whose age rouged overage 37 yeors, broLen into 52 female et 31 male, shows 83 cases of hydatic liv er-cystis that were aggravated by a BCF. In 23 cases (27,7 %) the BCF was large, minimal in 60 cases (72,3 %) and for 72 % the multivesicula r hydatic cystis was altered by a pericystis, often sclerous and calci fied. In 9 cases (11 %) the main biliary duct was enlarged and showed hydatic remeins. 3 patients were under radical treatment (3,6 %), 2 (2 ,45 %) underwent a total pericystectomy, and 1 (1,2 %) a partial peric ystectomy The 80 other patients went tarough a saving approach treatme nt which involved In 44 cases (55 %) aflattening with a simple suture of BCF, in 11 cases (13,75 %) a sature combined with an external bile drainage, in 5 cases (6,25 %) a sature combined with an epiploic-plast ic surgery, in 5 cases (6,25 %) the sature was combined with the paddi ng of the residual cavity, in 4 cases (5 %) in epiploic plastic surger y was combined with an external bile drainage. In 7 cases (8,75 %) a b ipolar drainage was used and in 4 cases (5 %) there as mobile drainage . For 50 % of these patients the post surgical surgery was very simple ; the most important aggravations were 12 FBK, 8 subphrenic abscess, 1 choleperitonitis. The average length of stay was 23 days. No death w as accountedfor. The aim was to assess the different technics proposed in the treatment of BCF and eleborate a therapeutical stategy.