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Endoscopic retrograde cholangiopancreatography in hepatic alveolar echinococcosis
Author(s) -
Ozturk Gurkan,
Polat Kamil Yalcin,
Yildirgan Mehmet Ilhan,
Aydinli Bulent,
Atamanalp Sabri Selcuk,
Aydin Unal
Publication year - 2009
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.05877.x
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , biliary fistula , common hepatic duct , common bile duct , jaundice , biliary tract , fistula , stent , left hepatic duct , bile duct , biliary colic , gastroenterology , surgery , radiology , gallbladder , pancreatitis
Abstract Background and Aim: Hepatic alveolar echinococcosis (HAE) involves both the vascular and biliary structures of the liver. Endoscopic retrograde cholangiopancreatography (ERCP) is said to be an alternative for the diagnosis and treatment of biliary complications of HAE. We present here our experience with ERCP in HAE. Methods: We followed 13 patients who underwent ERCP for the treatment of biliary complications of HAE in the endoscopy unit of our clinic at Ataturk University School of Medicine, Erzurum between January 2002 and June 2008. Results: Eight men and five women were followed up. Mean age was 43.2 (24–64 years). All patients had non‐resectable HAE. Indications for ERCP were biliary fistula in seven patients, obstructive jaundice in five patients and cholangitis in one patient. Endoscopic sphincterotomy (ES) was carried out in 12 patients, and in one patient with biliary leakage, a stent was inserted into the right hepatic branch. ERCP findings were dilated common bile duct, irregular narrowing and distortion of the common bile duct and common hepatic duct, communication with the cystic cavity or biliocutaneous fistula and complete disappearance of the biliary tree above the level of the common hepatic duct or hepatic bifurcation. In patients with biliary leakage, biliary drainage decreased only in two patients after ERCP and in patients with obstructive jaundice, the high bilirubin levels decreased in only one patient. Conclusion: ERCP showed structural changes of the external biliary tract and ES has a limited effect on these changes and stents can be used in selected cases.