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  • Oral presentation
  • Open Access

Treatment of hydatid cyst and bilio-bronchial and bilio-pleuro-bronchial fistulas via thoracotomy and transdiafragmal approach from October 2005 to October 2012 in a single unit in Tirana, Albania

  • 1Email author,
  • 1,
  • 2,
  • 2,
  • 2,
  • 3,
  • 3,
  • 3,
  • 1 and
  • 1
Journal of Cardiothoracic Surgery20138 (Suppl 1) :O257

https://doi.org/10.1186/1749-8090-8-S1-O257

  • Published:

Keywords

  • Abdominal Ultrasonography
  • Chest Radiography
  • Single Unit
  • Pulmonary Complication
  • Hydatid Cyst

Background

The aim of this study was to report the results of surgical treatment of hydatid bilio-bronchial et bilio-pleuro-bronchial fistulas via thoracotomy and transdiafragmal approach.

Methods

From October 2005 to October 2012, 13 cases were observed in the same center. Biliptysis was the main symptom in 80% of cases. The diagnosis was based on chest radiography ,thoracic and abdominal CT and abdominal ultrasonography, fibrobronchoscopy; all examinations visualised the cyst, intrathoracic collections, a diaphragmatic breach and biliary lesions. All patients were treated by one-stage thoracotomy. The procedures consisted of lung resection (lobectomy and/or segmentectomy) (n=11) and decortication (n=6) in the chest, cyst dome resection (n=13) or part pericystectomy (n=2) in the abdomen and suture and plastic of the diaphragmatic defect in all cases after hepato-diaphragmatic deconnection. An additional laparotomy was not necessary in all cases.

Results

There were 2 deaths (15.3%):no one intraoperative death and two postoperative deaths, mostly related to pulmonary complications. Postoperative complications (14.3%) were mainly respiratory. Clinical and radiological results were good with a one-year follow-up.

Conclusions

Bilio-bronchial and bilio-pleurobronchial fistulas due to hydatid cyst are rare, but severe diseases. They are responsible for lesions at three levels: abdominal, diaphragmatic and thoracic. A high perioperative mortality rate was observed. Thoracotomy with transdiafragmal approach is the best approach for surgical treatment at all three levels.

Authors’ Affiliations

(1)
Thorax Surgery Department, University Hosptal "Shefqet Ndroqi", Tirana, Albania
(2)
Anesthesiology and Reanimation Department, University Hosptal "Shefqet Ndroqi", Tirana, Albania
(3)
Pneumology Department, University Hosptal "Shefqet Ndroqi", Tirana, Albania

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