Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter?

Abstract Background The aim of this study was to determine if there is any predictive factor indicating the risk of bile leakage before surgery for hepatic hydatid disease in clinically asymptomatic patients. Methods The data of 116 patients who underwent surgery for hepatic hydatid disease were rev...

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Veröffentlicht in:The American journal of surgery 2008-11, Vol.196 (5), p.732-735
Hauptverfasser: Kilic, Mehmet, M.D, Yoldas, Omer, M.D, Koc, Mahmut, M.D, Keskek, Mehmet, M.D, Karakose, Nazile, M.D, Ertan, Tamer, M.D, Gocmen, Erdal, M.D, Tez, Mesut, M.D
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container_issue 5
container_start_page 732
container_title The American journal of surgery
container_volume 196
creator Kilic, Mehmet, M.D
Yoldas, Omer, M.D
Koc, Mahmut, M.D
Keskek, Mehmet, M.D
Karakose, Nazile, M.D
Ertan, Tamer, M.D
Gocmen, Erdal, M.D
Tez, Mesut, M.D
description Abstract Background The aim of this study was to determine if there is any predictive factor indicating the risk of bile leakage before surgery for hepatic hydatid disease in clinically asymptomatic patients. Methods The data of 116 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively. There were 43 men (37%) and 73 women (63%) with a mean age of 45 ± 15 years. Because of high preoperative serum bilirubin and liver function test levels, 12 patients were excluded from the study. These patients underwent preoperative endoscopic retrograde cholangiopancreatography. In addition, 2 medically treated patients were excluded from the study. The following variables were analyzed as potential predictors of biliary-cyst communication: age, sex, physical examination findings, leukocyte count, liver function test results, and ultrasonographic cyst features (type, diameter, number, and localization). Results Bile leakage was detected in 24 out of 102 patients. There were no differences in age, sex, cyst type, alkaline phosphatase level, γ-glutamyl transpeptidase level, alanine aminotransferase level, aspartate aminotransferase level, bilirubin level, and number of cysts and cyst locations between the patients with and without bile leakage. The mean cyst size in patients with biliary leakage was 10.2 cm as compared with 6.1 cm in patients with no biliary leakage ( P < .05). When the cut-off value of cyst diameter was accepted as 7.5 cm, the specificity and sensitivity for biliary-cyst communication were 73% and 79%, respectively. Conclusions These data suggest that cyst diameter is an independent factor that is associated with a high risk of biliary-cyst communication in clinically asymptomatic patients. Preoperative endoscopic retrograde cholangiopancreatography should be performed in these asymptomatic patients to reduce the incidence of postoperative complications.
doi_str_mv 10.1016/j.amjsurg.2007.07.034
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Methods The data of 116 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively. There were 43 men (37%) and 73 women (63%) with a mean age of 45 ± 15 years. Because of high preoperative serum bilirubin and liver function test levels, 12 patients were excluded from the study. These patients underwent preoperative endoscopic retrograde cholangiopancreatography. In addition, 2 medically treated patients were excluded from the study. The following variables were analyzed as potential predictors of biliary-cyst communication: age, sex, physical examination findings, leukocyte count, liver function test results, and ultrasonographic cyst features (type, diameter, number, and localization). Results Bile leakage was detected in 24 out of 102 patients. There were no differences in age, sex, cyst type, alkaline phosphatase level, γ-glutamyl transpeptidase level, alanine aminotransferase level, aspartate aminotransferase level, bilirubin level, and number of cysts and cyst locations between the patients with and without bile leakage. The mean cyst size in patients with biliary leakage was 10.2 cm as compared with 6.1 cm in patients with no biliary leakage ( P &lt; .05). When the cut-off value of cyst diameter was accepted as 7.5 cm, the specificity and sensitivity for biliary-cyst communication were 73% and 79%, respectively. Conclusions These data suggest that cyst diameter is an independent factor that is associated with a high risk of biliary-cyst communication in clinically asymptomatic patients. Preoperative endoscopic retrograde cholangiopancreatography should be performed in these asymptomatic patients to reduce the incidence of postoperative complications.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2007.07.034</identifier><identifier>PMID: 18513700</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Bile ; Bile leakage ; Biliary Fistula - diagnosis ; Biliary Fistula - etiology ; Biological and medical sciences ; Chi-Square Distribution ; Cholangiopancreatography, Endoscopic Retrograde ; Communication ; Cysts ; Diseases caused by cestodes ; Echinococcoses ; Echinococcosis, Hepatic - surgery ; ERCP ; Female ; General aspects ; Helminthic diseases ; Humans ; Hydatid disease ; Infectious diseases ; Leukocyte Count ; Liver Function Tests ; Male ; Medical sciences ; Middle Aged ; Parasitic diseases ; Patients ; Postoperative Complications - prevention &amp; control ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; ROC Curve ; Surgery ; Treatment Outcome</subject><ispartof>The American journal of surgery, 2008-11, Vol.196 (5), p.732-735</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jan 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-ae19f168b657ba4e214ecbcd0fcf5c7e90411d7de0358f189242e94536972bc53</citedby><cites>FETCH-LOGICAL-c476t-ae19f168b657ba4e214ecbcd0fcf5c7e90411d7de0358f189242e94536972bc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1444856064?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000,64390,64392,64394,72474</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20824458$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18513700$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kilic, Mehmet, M.D</creatorcontrib><creatorcontrib>Yoldas, Omer, M.D</creatorcontrib><creatorcontrib>Koc, Mahmut, M.D</creatorcontrib><creatorcontrib>Keskek, Mehmet, M.D</creatorcontrib><creatorcontrib>Karakose, Nazile, M.D</creatorcontrib><creatorcontrib>Ertan, Tamer, M.D</creatorcontrib><creatorcontrib>Gocmen, Erdal, M.D</creatorcontrib><creatorcontrib>Tez, Mesut, M.D</creatorcontrib><title>Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter?</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background The aim of this study was to determine if there is any predictive factor indicating the risk of bile leakage before surgery for hepatic hydatid disease in clinically asymptomatic patients. Methods The data of 116 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively. There were 43 men (37%) and 73 women (63%) with a mean age of 45 ± 15 years. Because of high preoperative serum bilirubin and liver function test levels, 12 patients were excluded from the study. These patients underwent preoperative endoscopic retrograde cholangiopancreatography. In addition, 2 medically treated patients were excluded from the study. The following variables were analyzed as potential predictors of biliary-cyst communication: age, sex, physical examination findings, leukocyte count, liver function test results, and ultrasonographic cyst features (type, diameter, number, and localization). Results Bile leakage was detected in 24 out of 102 patients. There were no differences in age, sex, cyst type, alkaline phosphatase level, γ-glutamyl transpeptidase level, alanine aminotransferase level, aspartate aminotransferase level, bilirubin level, and number of cysts and cyst locations between the patients with and without bile leakage. The mean cyst size in patients with biliary leakage was 10.2 cm as compared with 6.1 cm in patients with no biliary leakage ( P &lt; .05). When the cut-off value of cyst diameter was accepted as 7.5 cm, the specificity and sensitivity for biliary-cyst communication were 73% and 79%, respectively. Conclusions These data suggest that cyst diameter is an independent factor that is associated with a high risk of biliary-cyst communication in clinically asymptomatic patients. Preoperative endoscopic retrograde cholangiopancreatography should be performed in these asymptomatic patients to reduce the incidence of postoperative complications.</description><subject>Adult</subject><subject>Bile</subject><subject>Bile leakage</subject><subject>Biliary Fistula - diagnosis</subject><subject>Biliary Fistula - etiology</subject><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Communication</subject><subject>Cysts</subject><subject>Diseases caused by cestodes</subject><subject>Echinococcoses</subject><subject>Echinococcosis, Hepatic - surgery</subject><subject>ERCP</subject><subject>Female</subject><subject>General aspects</subject><subject>Helminthic diseases</subject><subject>Humans</subject><subject>Hydatid disease</subject><subject>Infectious diseases</subject><subject>Leukocyte Count</subject><subject>Liver Function Tests</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parasitic diseases</subject><subject>Patients</subject><subject>Postoperative Complications - prevention &amp; 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Yoldas, Omer, M.D ; Koc, Mahmut, M.D ; Keskek, Mehmet, M.D ; Karakose, Nazile, M.D ; Ertan, Tamer, M.D ; Gocmen, Erdal, M.D ; Tez, Mesut, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-ae19f168b657ba4e214ecbcd0fcf5c7e90411d7de0358f189242e94536972bc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Bile</topic><topic>Bile leakage</topic><topic>Biliary Fistula - diagnosis</topic><topic>Biliary Fistula - etiology</topic><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Communication</topic><topic>Cysts</topic><topic>Diseases caused by cestodes</topic><topic>Echinococcoses</topic><topic>Echinococcosis, Hepatic - surgery</topic><topic>ERCP</topic><topic>Female</topic><topic>General aspects</topic><topic>Helminthic diseases</topic><topic>Humans</topic><topic>Hydatid disease</topic><topic>Infectious diseases</topic><topic>Leukocyte Count</topic><topic>Liver Function Tests</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Parasitic diseases</topic><topic>Patients</topic><topic>Postoperative Complications - prevention &amp; 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Methods The data of 116 patients who underwent surgery for hepatic hydatid disease were reviewed retrospectively. There were 43 men (37%) and 73 women (63%) with a mean age of 45 ± 15 years. Because of high preoperative serum bilirubin and liver function test levels, 12 patients were excluded from the study. These patients underwent preoperative endoscopic retrograde cholangiopancreatography. In addition, 2 medically treated patients were excluded from the study. The following variables were analyzed as potential predictors of biliary-cyst communication: age, sex, physical examination findings, leukocyte count, liver function test results, and ultrasonographic cyst features (type, diameter, number, and localization). Results Bile leakage was detected in 24 out of 102 patients. There were no differences in age, sex, cyst type, alkaline phosphatase level, γ-glutamyl transpeptidase level, alanine aminotransferase level, aspartate aminotransferase level, bilirubin level, and number of cysts and cyst locations between the patients with and without bile leakage. The mean cyst size in patients with biliary leakage was 10.2 cm as compared with 6.1 cm in patients with no biliary leakage ( P &lt; .05). When the cut-off value of cyst diameter was accepted as 7.5 cm, the specificity and sensitivity for biliary-cyst communication were 73% and 79%, respectively. Conclusions These data suggest that cyst diameter is an independent factor that is associated with a high risk of biliary-cyst communication in clinically asymptomatic patients. Preoperative endoscopic retrograde cholangiopancreatography should be performed in these asymptomatic patients to reduce the incidence of postoperative complications.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18513700</pmid><doi>10.1016/j.amjsurg.2007.07.034</doi><tpages>4</tpages></addata></record>
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subjects Adult
Bile
Bile leakage
Biliary Fistula - diagnosis
Biliary Fistula - etiology
Biological and medical sciences
Chi-Square Distribution
Cholangiopancreatography, Endoscopic Retrograde
Communication
Cysts
Diseases caused by cestodes
Echinococcoses
Echinococcosis, Hepatic - surgery
ERCP
Female
General aspects
Helminthic diseases
Humans
Hydatid disease
Infectious diseases
Leukocyte Count
Liver Function Tests
Male
Medical sciences
Middle Aged
Parasitic diseases
Patients
Postoperative Complications - prevention & control
Predictive Value of Tests
Retrospective Studies
Risk Assessment
ROC Curve
Surgery
Treatment Outcome
title Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease: does size matter?
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