Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15253
Revised: April 30, 2014
Accepted: June 12, 2014
Published online: November 7, 2014
Processing time: 238 Days and 11.1 Hours
Most cases of hepatic hydatid disease exhibit uncomplicated clinical course and management. However, the diagnosis and management of complicated hepatic hydatid disease is a special issue. One of the most common and serious complications of hepatic hydatid disease is the rupture of the cyst into intrahepatic bile ducts. The clinical appearance of intrabiliary rupture can range from asymptomatic to jaundice, cholecystitis, cholangitis, liver abscess, pancreatitis and septicemia. Current treatments for major ruptures can result in high morbidity and mortality rates. Furthermore, ruptures that cannot be diagnosed preoperatively can induce complications such as biliary fistulae, biloma, cavitary infection and obstructive jaundice. In the past, these complications were diagnosed and treated by surgical methods. Currently, complications in both the pre- and postoperative periods are diagnosed and treated by non-invasive or minimally invasive methods. In clinical practice, endoscopic retrograde cholangiopancreatography (ERCP) is indicated for patients with preoperative frank intrabiliary rupture in which hydatid elements are clearly seen in the bile ducts, or for biliary adverse events after surgery, including persistent biliary fistulae and jaundice. However, controversy concerning routine preoperative ERCP and prophylactic endoscopic sphincterotomy in patients suspected of having minor cystobiliary communications still remains. In this article, the role of ERCP in the diagnosis and management of hepatic hydatid disease during the pre- and postoperative periods is reviewed.
Core tip: Intrabiliary rupture is the most common and serious complication of hepatic hydatid disease. In the past, all the complications due to the intrabiliary rupture were diagnosed and treated by surgical methods, whereas nowadays these complications in both the pre- and the postoperative periods can be diagnosed and treated by non-invasive or minimally invasive methods such as endoscopic retrograde cholangiopancreatography (ERCP). The primary aim of this review was to analyze the efficacy of ERCP in diagnosis and treatment of hepatic hydatid disease during the pre- and postoperative periods.