Biliary fistula after treatment for hydatid disease of the liver: When to intervene

Table 1 Preoperative characteristics of patients with hydatid disease of the liver (mean ± SD)

	Bile fistula		P value
	Absent	Present
Age, yr	32.0	31.5	0.8
Gender (M/F)	179/57	38/8	0.3
Cholangitis	6 (3%)	24 (52%)	< 0.001
Albendazol treatment	118 (50%)	23 (50%)	0.7
AST (U/L)	221.0 ± 32.2	44.0 ± 36.0	0.5
ALT (U/L)	223.0 ± 41.2	44.0 ± 38.4	0.8
ALP (U/L)	40.0 ± 235.1	190.0 ± 167.3	0.02
GGT (U/L)	25.0 ± 71.7	151.0 ± 64.3	0.08
Total bilirubin (mg/dL)	0.9 ± 1.44	1.5 ± 3.0	0.05
White blood cell	8077.3 ± 2945.0	8802.2 ± 3222.7	0.1

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyltranspeptidase.

Table 2 Characteritics of hydatid cysts in patients with hydatid disease of the liver (mean ± SD)

Cyst	Bile fistula		P value
	Absentn = 236	Presentn = 46
Size localisation (cm)
Diameter	8.46 ± 3.52	10.59 ± 3.74	0.0001
Right lobe	127 ± 45.9	23 ± 8.2	0.2
Left lobe	36 ± 12.8	3 ± 1.1
Bilobar	73 ± 25.9	20 ± 7.1
Type
I	68 ± 24.4	11 ± 3.9	0.7
II	30 ± 10.8	5 ± 1.8
III	102 ± 36.6	102 ± 36.6
IV	30 ± 10.8	5 ± 1.8
V	3 ± 1.1	0
Operation type, n (%)
Conservative surgery	173 (61.3)	37 (13.1)	0.4
Radical surgery	30 (10.6)	3 (1.1)
PAIR	33 (11.7)	6 (2.1)

PAIR: Puncture, aspiration, injection and reaspiration.

Table 3 Postoperative characteristics of patients with postoperative biliary fistula (mean ± SD)

	Biliary fistula closed		P value
	Spontaneousn = 12	Interventıonn = 34
Maximum output (mL)	81.6 ± 118.1	423.9 ± 298.4	< 0.001
Drain removal (d)	13.0 ± 6.0	27.1 ± 12.8	0.001
Maximum cyst diameter (cm)	9.9 ± 4.1	10.8 ± 3.6	0.4
Time to fistula closure (d)	10.1 ± 3.7	30.7 ± 15.1	< 0.001
Time to intervention (d)	10.1 ± 3.7	11.4 ± 6.7	0.5
Hospitalization (d)	22.4 ± 17.9	11.4 ± 6.7	< 0.001