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<p>The management of liver hydatid cysts (LHC) is challenging. Surgery is widely recognized as the optimal treatment; however, postoperative bile leaks (POBL) and recurrence can occur. This study aims to evaluate surgical outcomes of LHC, with particular focus on risk factors associated with POBL and the potential for spontaneous resolution. This was a prospective cross-sectional study. Inclusion criteria encompassed patients with symptomatic and peripherally located LHC. Patients with small intraparenchymal liver cysts, incomplete records, or surgical contraindications were excluded. The surgery involved open approaches for cyst evacuation and management of cysto-biliary communication. Postoperatively, patients received albendazole and had regular follow-up appointments for up to 5 years. The study comprised 125 patients, 54 males (43.2%) and 71 females (56.8%). The mean age was 39.9 years. The primary symptom was right upper quadrant pain (66.4%). Single cysts were observed in 80 cases (64%) and multiple cysts in 45 (36%). The cysts were mainly located in the right lobe (64%), with a mean cyst size of 87 mm. The POBL occurred in 25 patients (20%), with 56% resolving with conservative treatment. The recurrence rate after a median follow-up of 26 months was 1.6%. None of the demographic data, cyst characteristics, or procedures significantly affected POBL development. The size of LHCs is not a preoperative predictor for POBL. Most POBL can be managed conservatively, with a waiting time of 3 weeks. Perioperative bile leaks may not progress to POBL, so aggressive operative management may not be indicated.</p>

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Bile Leak after Liver Hydatid Cysts Surgery: Predictions and Management

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • Deari Ahmed Ismaeil,
  • Barham M M Salih,
  • Dara Ahmed Mohammed,
  • Hemn Hussain Kaka Ali,
  • Dlshad Hama Saeed Ahmed,
  • Omar Hama Ghalib Hawrami,
  • Wirya Nasih Saber,
  • Aland Sardar Noori,
  • Hardi Mohammed Dhahir

摘要

The management of liver hydatid cysts (LHC) is challenging. Surgery is widely recognized as the optimal treatment; however, postoperative bile leaks (POBL) and recurrence can occur. This study aims to evaluate surgical outcomes of LHC, with particular focus on risk factors associated with POBL and the potential for spontaneous resolution. This was a prospective cross-sectional study. Inclusion criteria encompassed patients with symptomatic and peripherally located LHC. Patients with small intraparenchymal liver cysts, incomplete records, or surgical contraindications were excluded. The surgery involved open approaches for cyst evacuation and management of cysto-biliary communication. Postoperatively, patients received albendazole and had regular follow-up appointments for up to 5 years. The study comprised 125 patients, 54 males (43.2%) and 71 females (56.8%). The mean age was 39.9 years. The primary symptom was right upper quadrant pain (66.4%). Single cysts were observed in 80 cases (64%) and multiple cysts in 45 (36%). The cysts were mainly located in the right lobe (64%), with a mean cyst size of 87 mm. The POBL occurred in 25 patients (20%), with 56% resolving with conservative treatment. The recurrence rate after a median follow-up of 26 months was 1.6%. None of the demographic data, cyst characteristics, or procedures significantly affected POBL development. The size of LHCs is not a preoperative predictor for POBL. Most POBL can be managed conservatively, with a waiting time of 3 weeks. Perioperative bile leaks may not progress to POBL, so aggressive operative management may not be indicated.