E-ISSN 2146-8133
 

Original Research (Original Article) 


A study on evaluation of biliary leaks following hydatid liver surgeries

Hanief Mohamed Dar, Mumtazuddin Wani, Mir Mujtaba Ahmmad, Parvaze Salam.

Abstract
Background: A high incidence of post-operative bile leaks is reported to be a significant disadvantage of conservative surgical procedures.
Materials and Methods: One hundred patients with 180 cysts were operated upon using conservative surgical techniques from May 2007 to November 2009.
Results: Post-operative biliary leakage occurred in 26 (26%) patients. Independent clinical predictors for post-operative bile leak were raised alkaline phosphatase and gamma-glutamyl transpeptidase levels (P < 0.05), cyst content being bilious and/or containing pus (P < 0.05), a greater number of cysts (P < 0.05), and radiological appearance of cysts whether, multilocular or degenerated (P > 0.05). Post-operative complications were seen in 21 patients (21%). Complications were seen in 12 of 26 patients with bile leak (46.16%) and in 9 patients among 74 patients (12.16%) without a bile leak (P < 0.05). The mean hospital stay for patients with biliary leakage was 15 days, while the mean hospital stay for patients with no biliary leakage was 8 days. In all patients (22 patients) with low output fistulas (<300 ml/day), the leak was stopped by conservative means in 4 weeks. Among 4 patients with high output fistulas (>300 ml/day), 3 patients were managed conservatively, and in one patient there were no signs of a reduction in bile leakage even after 4 weeks; in this case, endoscopic retrograde cholangiopancreatography with a sphincterotomy was performed, which led to the healing of the fistula 1 week after the endoscopic sphincterotomy.
Conclusion: Biliary leakage is common following conservative surgery and is the main cause of post-operative morbidity. Most of the bile leaks can be prevented by thorough inspection of the cavity peroperatively for cyst-biliary communication. Identifying risk factors preoperatively may help to optimize perioperative management. Most bile leaks heal by conservative management.

Key words: Biliary leak, conservative surgery, cyst-biliary communications, cystectomy, hydatid liver


 
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How to Cite this Article
Pubmed Style

Dar HM, Wani M, Ahmmad MM, Salam P. A study on evaluation of biliary leaks following hydatid liver surgeries. Arch Clin Exp Surg. 2015; 4(2): 89-94. doi:10.5455/aces.20141116115636


Web Style

Dar HM, Wani M, Ahmmad MM, Salam P. A study on evaluation of biliary leaks following hydatid liver surgeries. http://www.ejmaces.com/?mno=162582 [Access: August 17, 2018]. doi:10.5455/aces.20141116115636


AMA (American Medical Association) Style

Dar HM, Wani M, Ahmmad MM, Salam P. A study on evaluation of biliary leaks following hydatid liver surgeries. Arch Clin Exp Surg. 2015; 4(2): 89-94. doi:10.5455/aces.20141116115636



Vancouver/ICMJE Style

Dar HM, Wani M, Ahmmad MM, Salam P. A study on evaluation of biliary leaks following hydatid liver surgeries. Arch Clin Exp Surg. (2015), [cited August 17, 2018]; 4(2): 89-94. doi:10.5455/aces.20141116115636



Harvard Style

Dar, H. M., Wani, M., Ahmmad, M. M. & Salam, P. (2015) A study on evaluation of biliary leaks following hydatid liver surgeries. Arch Clin Exp Surg, 4 (2), 89-94. doi:10.5455/aces.20141116115636



Turabian Style

Dar, Hanief Mohamed, Mumtazuddin Wani, Mir Mujtaba Ahmmad, and Parvaze Salam. 2015. A study on evaluation of biliary leaks following hydatid liver surgeries. Archives of Clinical and Experimental Surgery (ACES), 4 (2), 89-94. doi:10.5455/aces.20141116115636



Chicago Style

Dar, Hanief Mohamed, Mumtazuddin Wani, Mir Mujtaba Ahmmad, and Parvaze Salam. "A study on evaluation of biliary leaks following hydatid liver surgeries." Archives of Clinical and Experimental Surgery (ACES) 4 (2015), 89-94. doi:10.5455/aces.20141116115636



MLA (The Modern Language Association) Style

Dar, Hanief Mohamed, Mumtazuddin Wani, Mir Mujtaba Ahmmad, and Parvaze Salam. "A study on evaluation of biliary leaks following hydatid liver surgeries." Archives of Clinical and Experimental Surgery (ACES) 4.2 (2015), 89-94. Print. doi:10.5455/aces.20141116115636



APA (American Psychological Association) Style

Dar, H. M., Wani, M., Ahmmad, M. M. & Salam, P. (2015) A study on evaluation of biliary leaks following hydatid liver surgeries. Archives of Clinical and Experimental Surgery (ACES), 4 (2), 89-94. doi:10.5455/aces.20141116115636





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